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San Diego County
H0148_20_141A_PNO_SD_TA_Accepted 11/22/2020
Direktoryo ng Provider at Parmasya Blue Shield Promise Cal MediConnect Plan
(Medicare-Medicaid Plan)
2021
Blue Shield Promise Cal MediConnect Plan | 2021 Direktoryo ng Provider at Botika
Panimula
Isinasama nitong Direktoryo ng Provider at Parmasya ang impormasyon tungkol sa mga uri
ng provider at parmasya sa Blue Shield Promise Cal MediConnect Plan at mga lista ng lahat
ng provider at parmasya ng plan hanggang sa petsa nitong Direktoryo. Naglalaman ang
lista ng mga address at impormasyon sa pakikipag-ugnayan ng provider at parmasya pati
na rin ng iba pang detalye gaya ng mga araw at oras ng operasyon, mga espesyalidad, at
mga kasanayan. Makikita ang mga pangunahing salita at ang kanilang mga kahulugan sa
pagkakasunud-sunod ayon sa alpabeto sa huling kabanata ng Handbook ng Miyembro.
Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa
1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para
sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.
I
II
Talaan ng mga Nilalaman A. Mga Pagtatatuwa ng Pananagutan ........................................................................VI
B. Mga Provider ................................................................................................................. IX
B1. Mahahalagang termino ........................................................................................ IX
B2. Pagpili ng Primary Care Physician (PCP) .............................................................X
B3. Mga pangmatagalang serbisyo at suporta (Long-term services and supports
LTSS) ................................................................................................................................XI
B4. Paano tukuyin ang mga provider sa network ng Blue Shield Promise Cal
MediConnect Plan .......................................................................................................XII
B5. Paano mahanap ang mga provider ng Blue Shield Promise Cal MediConnect
Plan sa vinyong lugar ...................................................................................................XIII
B6. Listahan ng mga provider sa network .................................................................XV
B7. Ang iyong Mga Karagdagang Benepisyo ..........................................................XV
C. Listahan ng network ng mga botika .........................................................................XVII
C1. Paano tukuyin ang mga botika sa network ng Blue Shield Promise Cal
MediConnect Plan .......................................................................................................XVII
C2. Mga pangmatagalang supply ng mga reseta .................................................XVIII
D. Mga provider sa network ng Blue Shield Promise Cal MediConnect Plan
BLUE SHIELD PROMISE HEALTH PLAN DIRECT
COMMUNITY CARE IPA LLC
GREATER TRI CITIES IPA MEDICAL GROUP INC
HEALTH EXCEL IPA INC
PRIMARY CARE ASSOCIATES OF CALIFORNIA OF SAN DIEGO
SHARP COMM MEDICAL GROUP DUAL PLUS-CHULA VISTA
SHARP COMM MEDICAL GROUP DUAL PLUS-CORONADO
Mga espesyalista ..............................................................................................................1
Mga pangunahing doktor sa pangangalaga ..............................................................12
Mga espesyalista ..............................................................................................................29
Mga pangunahing doktor sa pangangalaga ..............................................................284
Mga espesyalista ..............................................................................................................288
Mga pangunahing doktor sa pangangalaga ..............................................................296
Mga espesyalista ..............................................................................................................331
Mga pangunahing doktor sa pangangalaga ..............................................................558
Mga espesyalista ..............................................................................................................576
Mga pangunahing doktor sa pangangalaga ..............................................................608
Mga espesyalista ..............................................................................................................615
Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan
sa 1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag.
Para sa karagdagang impormasyon, bumisita sa
www.blueshieldca.com/promise/calmediconnect.
III
Mga pangunahing doktor sa pangangalaga ..............................................................642
SHARP COMM MEDICAL GROUP DUAL PLUS-GRAYBILL
SHARP COMM MEDICAL GROUP DUAL PLUS-GROSSMONT
SHARP COMM MEDICAL GROUP DUAL PLUS-INLAND NORTH
SHARP COMM MEDICAL GROUP DUAL PLUS-METRO
UCSD MEDICAL GROUP
Mga espesyalista ..............................................................................................................644
Mga pangunahing doktor sa pangangalaga ..............................................................686
Mga espesyalista ..............................................................................................................693
Mga pangunahing doktor sa pangangalaga ..............................................................732
Mga espesyalista ..............................................................................................................737
Mga pangunahing doktor sa pangangalaga ..............................................................790
Mga espesyalista ..............................................................................................................792
Mga pangunahing doktor sa pangangalaga ..............................................................825
Mga espesyalista ..............................................................................................................829
Mga espesyalista ..............................................................................................................879
D2. Acupuncture, Dental, Kalusugan sa bahay, Kalusugang pangkaisipan, at
Tagapagbigay ng Vision
Acupuncture .....................................................................................................................1073
Kalusugan sa bahay .........................................................................................................1218
Tagapagbigay ng Dental ................................................................................................1223
Kalusugang pangkaisipan ...............................................................................................1224
Tagapagbigay ng Vision ..................................................................................................1255
D3. Mga Ospital, Mga Serbisyo sa Suporta sa Pangmatagalang, Mga Pasilidad sa
Kalusugan ng Isip, Mga Pasilidad sa Pag-aalaga at mga Skilled Nursing Facility
Mga Ospital .......................................................................................................................1319
Mga Serbisyo sa Suporta sa Pangmatagalang ............................................................1323
Mga Pasilidad sa Kalusugan ng Isip ...............................................................................1324
Mga Pasilidad sa Pag-aalaga ........................................................................................1338
E. Mga botika sa network ng Blue Shield Promise Cal MediConnect Plan
E1. Tingian at chain ng mga botika ............................................................................1359
E2. Mail order na parmasya ............................................................................................1399
E3. Mga home infusion na botika ...............................................................................1400
E4. Mga Botika para sa pangmatagalang pangangalaga ...................................1401
E5. Indian Health Service/ Tribal/ Urban Indian Health Program (I/T/U) pharmacies
1405
F. Index of Mga Tagapagkaloob at mga parmasya
F1. Mga Tagapagkaloob .............................................................................................1406
Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan
sa 1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag.
Para sa karagdagang impormasyon, bumisita sa
www.blueshieldca.com/promise/calmediconnect.
IV
F2. Mga parmasya ........................................................................................................1433
Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan
sa 1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag.
Para sa karagdagang impormasyon, bumisita sa
www.blueshieldca.com/promise/calmediconnect.
V
A. Mga Pagtatatuwa ng Pananagutan
� Ang Blue Shield Promise Cal MediConnect Plan ay isang planong pangkalusugan
na nakikipagkontrata sa parehong Medicare at Medi-Cal upang ibigay ang mga
benepisyo ng parehong programa sa mga nagpapatala.
� Ang Listahan ng Mga Sinasaklaw na Gamot at/o mga network ng botika at provider
ay maaaring magbago sa buong taon. Padadalhan ka namin ng abiso bago kami
gumawa ng pagbabagong makakaapekto sa iyo.
� Maaaring magbago ang mga benepisyo at/o copay sa Enero 1 ng bawat taon.
� Kabilang sa Direktoryo ang mga provider na nagbibigay ng mga serbisyo sa parehong
Medicare at Medi-Cal.
� Nakatala sa Direktoryong ito ang mga health care professional (tulad ng mga doktor,
nurse practitioner, at psychologist), pasilidad (tulad ng mga ospital o klinika), at provider
ng suporta (tulad ng mga provider ng Kalusugan sa Araw ng Mga Nasa Hustong Gulang
at Kalusugan sa Tahanan) na maaari mong makita bilang miyembro ng Blue Shield
Promise Cal MediConnect Plan. Itinatala rin namin ang mga botikang maaari mong
gamitin upang makuha ang iyong mga resetang gamot.
� Tutukuyin namin ang mga grupong ito bilang “mga provider ng network” sa
Direktoryong ito. Lumagda ang mga provider na ito ng kontrata sa amin upang
magbigay sa iyo ng mga serbisyo. Ito ay isang listahan ng mga provider sa network ng
Blue Shield Promise Cal MediConnect Plan para sa San Diego County.
Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa
1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para
sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.
VI
English: If you speak English, language assistance services, free of charge, are
available to you. Call 1-855-905-3825 (TTY users should call 711). 8:00 a.m –
8:00 p.m., seven days a week. The call is free.
Español
(Spanish):
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de
asistencia lingüística. Llame al Blue Shield Promise Cal-MediConnect
1-855-905-3825 (TTY: 711) De 8:00 a.m. a 8:00 p.m., los siete días de la semana.
繁體中文 ( Chinese):
繁體中文 (Chinese): 注意:如果您使用繁體中文,您可以免費獲得語言援助服
務。請致電 Blue Shield Promise Cal-MediConnect 1-855-905-3825 (TTY: 711) 每周七天办公,每天早上 8:00 至晚上 8:00。这是免费电话。
Tiếng Việt
(Vietnamese):
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho
bạn. Gọi số Blue Shield Promise Cal-MediConnect 1-855-905-3825 (TTY: 711) 8 giờ sáng–8 giờ tối, 7 ngày trong tuần. HOẶC Ban.
Tagalog
(Tagalog – Filipino):
PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga
serbisyo ng tulong sa wika nang walang bayad. Tumawag sa Blue Shield Promise
Cal-MediConnect 1-855-905-3825 (TTY: 711) Mula 8am-8pm, 7 araw sa isang lingo.
한국어 (Korean):
주의 : 한국어를 사용하시는 경우 , 언어 지원 서비스를 무료로 이용하실 수 있습 니다 . Blue Shield PromiseCal-MediConnect 1-855-905-3825 (TTY: 711) 번으로 전화해 주십시오 . 번으로 전화해 주십시오 , 오후 8 시 , 7 일 주일 오전 8 시 .
Հայերեն (Armenian):
�ՇԱԴՐ�ԹՅ�Ն՝ Եթե խոս�մ եք հայերեն, ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցո թյան ծառայո թյո ններ:
Զանգահարեք Blue Shield Promise Cal-MediConnect 1-855-905-3825 (TTY
(հեռատիպ)՝ 711) Ից 8:00 – 20:00, շաբաթը յոթ օր
یسراف(Persian/Farsi):
با . باشد می فراھم شما برای رایگان بصورت زبانی تسھیلات کنید، می گفتگو فارسی زبان بھ اگر : توجھ با . باشد (TTY: 711) ھفتھ روزه ھمھ شب، 8 تا صبح . 8 بگیرید تماس 1-855-905-3825
Русский (Russian):
ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните Blue Shield Promise Cal-MediConnect
1-855-905-3825 (телетайп: 711) С 8:00 до 20:00, без выходных.
日本語 (Japanese):
注意事項:日本語を話される場合、無料の言語支援をご利用いただけま
す。 Blue Shield Promise Cal-MediConnect 1-855-905-3825 (TTY:711) まで、お電話にてご連絡ください。毎日 8am~ 8pm
ةيبرعلا(Arabic):
بالرقم اتصل . لك متوفرة ، ا ً مجان ، اللغة مساعدة خدمات فإن ، العربیة تتحدث كنت إذاً ً صباح 8:00 .(711 بالرقم الاتصال مستخدمي على یجب TTY ( 1-855-905-3825 ،مساء - 8:00 ا
مجانیة المكالمة . الأسبوع في أیام سبعة.
ਪੰਜਾਬੀ (Punjabi):
ਿਧ�� ਿ��: ਜੇ ਤੁਸੀਂ ਪੰਜਾਬੀ ਬੋਲ�ੇ ਹੋ� ਤਾਂ �ਾ�ਾ ਿਵੱਚ ਸਹਾਇਤਾ ਸੇਵਾ ਤੁਹਾਡੇ ਲਈ ਮੁਫਤ ਉਪਲਬਧ ਹੈ। Blue Shield Promise Cal-MediConnect 1-855-905-3825
(TTY:711) ‘ਤੇ ਕਾਲ ਕਰੋ।.ਸਵੇਰੇ 8 ਵਜੇ ਤੋਂ �ਾਮ 8 ਵਜੇ ਤੱਕ� ਹ�ਤੇ ਿਵਚ 7 ਿ��
�ខែរ (Cambodian/Khmer):
��
�
�
�
� �
�បែយ័ត: បែសិនបើអកនិ�យ��អែសែប៉ែញអក�នសែ�កមជំនួយ�� ឥតគិតថែ។ ទូរស័ព�� Cal-MediConnect 1-855-905-3825 (TTY: 711)
�ប់ពីម៉ែង 8:00 ពែឹក។ ម៉ែង 8 ពែឹកម៉ែង 7 ថែកុងមួយសបែហ៍។
Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa
1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para
sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.
VII
� Makukuha mo nang libre ang dokumentong ito sa iba pang format, gaya ng malalaking letra, braille, o audio. Tawagan ang Member Services sa 1-855-905-3825 (TTY: 711) 8:00
a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag.
� Maaari kang humiling na makakuha ng mga materyales sa wikang bukod sa English o
sa isang alternatibong format ngayon at sa hinaharap. Upang humiling, mangyaring
makipag-ugnayan sa Member Services ng Blue Shield Promise Cal MediConnect Plan. .
� Napapanahon ang listahang ito sa petsang 7/1/2021, ngunit kailangan mong malaman na:
• May ilang provider sa network ng Blue Shield Promise Cal MediConnect Plan na maaaring nadagdag o naalis mula sa aming network pagkatapos malimbag ang Direktoryong ito.
• May ilang provider ng Blue Shield Promise Cal MediConnect Plan sa aming network na maaaring hindi na tumatanggap ng mga bagong miyembro. Kung nahihirapan kang maghanap ng provider na tatanggap ng mga bagong miyembro, tumawag sa Member Services at 1-855-905-3825 (TTY: 711) ay tutulungan ka namin.
• Upang makuha ang pinakanapapanahong impormasyon tungkol sa mga provider sa network ng Blue Shield Promise Cal MediConnect Plan sa iyong lugar, bumisita sa www.blueshieldca.com/promise/calmediconnect o tumawag sa Member Services sa
1-855- 905-3825(TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag.
Nakalista ang mga doktor at iba pang health care professional sa network ng Blue
Shield Promise Cal MediConnect Plan’s sa pahina 1 - 1072. Nakalista ang
mga botika sa aming network sa pahina 1358 - 1405. Magagamit mo ang Indise sa likod ng Direktoryo upang mahanap ang pahina kung saan nakalista ang
provider o botika.
Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa
1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para
sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.
VIII
B. Mga Provider
B1. Mahahalagang termino
Ipinapaliwanag sa seksyong ito ang mahahalagang terminong makikita mo sa aming
Direktoryo ng Provider at Botika.
• Ang Mga Provider ay mga health care professional at provider ng suporta tulad
ng mga doktor, nars, pharmacist, therapist at iba pang taong nagbibigay ng
pangangalaga at mga serbisyo. Kabilang sa Mga Serbisyo ang medikal na
pangangalaga, mga pangmatagalang serbisyo at suporta (LTSS), supply, resetang
gamot, kagamitan at iba pang serbisyo.
○ Kabilang din sa terminong mga provider ang mga pasilidad tulad ng mga
ospital, klinika at iba pang lugar na nagbibigay ng serbisyong medikal,
kagamitang medikal at mga pangmatagalang serbisyo at suporta.
○ Ang mga provider na bahagi ng network ng aming plano ay tinatawag na
mga provider sa network.
• Ang mga provider sa network ay ang mga tagapagbigay ng serbisyo na
nakipagkontrata sa amin upang magbigay ng mga serbisyo sa mga miyembro sa
aming plano. Sa pangkalahatan, direkta kaming sinisingil ng mga provider sa aming
network para sa pangangalagang ibinibigay nila sa iyo. Kapag nagpatingin ka sa
isang provider na nasa network, karaniwang: wala kang babayaran para sa mga
saklaw na serbisyo.
• Ang Primary Care Physician (PCP) ay isang internist, family practitioner, general
practitioner, o espesyalistang nagbibigay sa iyo ng regular na pangangalagang
pangkalusugan. Itatago ng iyong PCP ang mga medikal na talaan mo at malalaman
ang iyong mga pangangailangang pangkalusugan sa paglipas ng panahon.
Bibigyan ka rin ng iyong PCP ng referral kung kailangan mong makakita ng
espesyalista o iba pang provider.
• Ang mga espesyalista ay mga doktor na nagbibigay ng serbisyo ng
pangangalagang pangkalusugan para sa partikular na sakit o bahagi ng katawan.
Mayroong maraming uri ng espesyalista. Narito ang ilang halimbawa:
○ Pangangalaga ng mga oncologist para sa mga pasyenteng may kanser.
○ Nangangalaga ang mga cardiologist ng mga pasyenteng may mga kondisyon
sa puso.
○ Nangangalaga ang mga orthopedist ng mga pasyenteng may mga partikular
na kondisyon sa buto, kasukasuan, o kalamnan.
• Ang Medikal na pangkat o hiwalay na samahan ng mga doktor (independent
physician association, IPA) ay isang organinasyong binuo sa bisa ng batas sa
California na nakikipagkontrata sa mga planong pangkalusugan para maghatid
o mag-asikaso para sa pagkakaloob ng mga serbisyo sa pangangalagang
pangkalusugan sa mga nakatala sa planong pangkalusugan.
Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa
1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para
sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.
IX
• Maaari kang mangailangan ng referral upang magpatingin sa isang espesyalista o sa
kaninuman na hindi mo PCP. Nangangahulugan ang referral na dapat kang bigyan
ng pag-apruba ng iyong primary care physician (PCP) para magpatingin sa ibang
doktor maliban sa iyong PCP. Kung hindi ka makakuha ng referral, maaaring hindi
saklawan ng Blue Shield Promise Cal MediConnect Plan ang serbisyo.
○ Hindi kailangan ng referral mula sa aming plano para sa:
– Emergency na pangangalaga;
– Pangangalagang maagap na kailangan;
– Mga serbisyo ng dialysis ng bato na natatanggap mo sa isang pasilidad ng
dialysis na Medicare-certifed kapag nasa labas ka ng lugar ng serbisyo ng
plano; o
– Mga serbisyo mula sa espesyalista ng kalusugan ng kababaihan.
– Lahat ng serbisyo ng pag-iwas sa sakit na nasasaklaw ng Medicare, kabilang
ang mga pagsusuri at bakuna.
• Dagdag pa rito, kung karapat-dapat kang makakuha ng mga serbisyo mula sa mga
Indian na provider ng kalusugan, maaari mong puntahan ang mga provider na ito
nang walang referral. Dapat naming bayaran ang Indian na provider ng kalusugan
para sa mga serbisyong iyon kahit na wala sila sa network ng aming plano.
○ Mababasa ang higit pang impormasyon tungkol sa mga referral sa Kabanata 3
ng Handbook ng Miyembro.
• May access ka rin sa isang Coordinator ng Pangangalaga at team ng pangangalaga
na may tulong ka sa pagpili.
○ Tinutulungan ka ng Coordinator ng Pangangalaga (Care Navigator) na
pamahalaan ang iyong mga medikal na provider at serbisyo.
○ Nagsisimula ang Team ng Pangangalaga sa pakikipag-ugnayan sa pagitan mo
at ng iyong PCP. Maaaring kabilangan ng Team ng Pangangalaga ang isang
tagapangalaga, Coordinator ng Pangangalaga, espesyalista, at iba pa, batay
sa antas ng pangangailangang lumalabas sa iyong Plano ng Pangangalaga.
Nagtutulungan ang lahat ng nasa team ng pangangalaga upang tiyaking
naka-coordinate ang pangangalaga sa iyo. Ang ibig sabihin nito ay tinitiyak
nilang minsan lang ginagawa ang mga pagsusuri at lab at naibabahagi ang
mga resulta sa mga naaangkop na provider. Ibig sabihin din nito na alam
dapat ng iyong PCP ang lahat ng iniinom mong gamot upang mabawasan
niya ang anumang negatibong epekto. Magtutulungan ang iyong Team
ng Pangangalaga upang bumuo, ipatupad at panatilihin ang iyong Plano
ng Pangangalaga. Laging hihingi ng iyong pahintulot ang iyong PCP bago
ibahagi ang iyong impormasyong medikal sa ibang mga provider.
B2. Pagpili ng Primary Care Physician (PCP)
Makakakuha ka ng mga serbisyo sa anumang provider na nasa aming network at
tumatanggap ng mga bagong miyembro.
Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa
1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para
sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.
X
Una, kakailanganin mong pumili ng Primary Care Physician. Maaaring espesyalista ang
magsilbing iyong PCP. Maaari kang pumili ng isang espesyalista bilang iyong PCP kung
sumasang-ayon ang espesyalista na ibigay ang lahat ng serbisyo na ibinibigay ng PCP ayon
sa kaugalian. Upang hilingin na ang iyong espesyalista ang maging PCP mo, makipag-
ugnayan sa Blue Shield Promise Cal MediConnect Plan Member Services.
Kaanib ang mga PCP ng aming plano sa mga medikal na pangkat. Kapag pumili ka ng
iyong PCP, pinipili mo na rin ang kaanib na medikal na pangkat. Ibig sabihin, ire-refer ka ng
iyong PCP sa mga espesyalista o serbisyong kaanib din ng kanyang medikal na pangkat.
• Kung mayroong partikular na espesyalista o ospital na gusto mong gamitin,
mahalagang tingnan kung kaanib sila sa medikal na pangkat ng iyong PCP. Maaari
kang tumingin sa direktoryong ito, o magtanong sa Member Services ng Blue
Shield Promise Cal MediConnect Plan upang suriin kung ang gusto mong PCP ay
gumagawa ng mga referral sa espesyalistang iyon o ginagamit ang ospital na iyon.
• Kung hindi ka mananatili sa medikal na pangkat ng iyong PCP, maaaring hindi
saklawan ng Blue Shield Promise Cal MediConnect Plan ang serbisyo.
Upang pumili ng PCP, pumunta sa listahan ng mga doktor sa pahina
1 - 1072 at pumili ng doktor:
• na ginagamit mo na, o
• na inirekomenda ng isang taong pinagkakatiwalaan mo, o
• na ang mga opisina ay madali mong mapupuntahan.
• Kung gusto mo ng tulong sa pagpili ng PCP, pakitawagan ang Member Services sa
1-855- 905-3825, 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag
(TTY: 711). O, bumisita sa www.blueshieldca.com/promise/calmediconnect.
• Kung mayroon kang mga tanong tungkol sa kung babayaran namin ang anumang
medikal na serbisyo o pangangalagang iyong gusto o kailangan, tumawag sa
Customer Care at magtanong bago mo makuha ang serbisyo o pangangalaga.
B3. Mga pangmatagalang serbisyo at suporta (Long-term services and supports, LTSS)
Bilang miyembro ng Blue Shield Promise Cal MediConnect Plan, maaari kang makakuha
ng mga pangmatagalang serbisyo at suporta (LTSS), tulad ng pangangalagang
pangkalusugan sa araw sa mga center na nagbibigay ng nursing, therapy, mga aktibidad
at pagkain sa mga taong may mga partikular na malubhang kundisyon sa kalusugan o
kundisyon sa kalusugan ng pag-iisip; Mga Pansuportang Serbisyo sa Tahanan (In-Home
Supportive Services, IHSS), para sa mga taong kailangan ng personal na pangangalaga
(o/at) tulong upang mabuhay nang ligtas sa tahanan; Programa ng Maraming
Serbisyo sa Matatanda (Multipurpose Senior Services Program, MSSP), nagbibigay ng
social na pamamahala at pamamahala sa pangangalagang pangkalusugan, para
sa matatandang kliyenteng maaaring ipasok sa nursing facility na gustong manatili sa
komunidad na nagbibigay ng medikal na kagamitan at supply tulad ng mga lampin at
serbisyo ng medikal na transportasyon. Tinutulungan ng LTSS ang mga tao na kailangan ng
tulong sa mga pang-araw-araw na gawain tulad ng pagligo, pagbihis, paghahanda ng
pagkain at pag-inom ng gamot. Karamihan sa mga serbisyong ito ay ibinibigay sa iyong
tahanan o sa komunidad mo ngunit maaaring ibigay sa isang nursing home o ospital.
Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa
1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para
sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.
XI
Kabilang sa mga serbisyong ito ang Mga Serbisyo sa Komunidad para sa Nasa Hustong
Gulang (Community-Based Adult Services, CBAS).
Ang CBAS ay isang programang pangkalusugan sa araw na nakabatay sa komunidad na
nagbibigay ng mga serbisyo sa mas matatandang tao at mga taong nasa hustong gulang
na may malubhang kundisyong medikal, kognitibo, o kalusugan sa pag-iisip at/o mga
kapansanang nanganganib na mangailangan ng pangangalagang institusyonal.
Upang mag-apply para sa CBAS, mangyaring tumawag sa Blue Shield Promise Cal
MediConnect Plan 1-855-905-3825 (TTY: 711), 8:00 a.m. hanggang 8:00 p.m. pitong araw sa
isang linggo.
Kabilang sa iba pang pangmatagalang serbisyo at suporta na ibinibigay ng Blue Shield
Promise Cal MediConnect Plan ang Multipurpose Senior Services Program (MSSP). Ang MSSP
ay isang Medicaid Waiver na programang pangangasiwa ng kaso para sa matatanda na
edad 65 at mas matanda na karapat-dapat para sa Medi-Cal at maaaring mapatunayan
para sa paglalagay sa isang pasilidad ng pagkalinga (nursing facility) ngunit nagnanais
na manatiling naninirahan sa komunidad. Nakikipagtulungan ang mga Tagapamahala
ng Pangangalaga ng MSSP sa mga benepisyaryo, sa mga miyembro ng kanilang
pamilya, at sa medical team upang tukuyin at isaayos ang mga serbisyo sa tahanan; Ang
Pangmatagalang Pangangalaga/Taga-ingat (Long-Term Care/Custodial, LTC) ay ang
pagbibigay ng mga serbisyong pangangalagang medikal, pakikisalamuha at personal
na ibinibigay sa mga tumatanggap ng Medi-Cal na hindi makapamuhay nang ligtas sa
tahanan ngunit hindi kailangang maging nasa ospital. Inilalagay ang mga indibidwal sa
antas ng pangangalaga na pinakaangkop para sa kanilang mga pangangailangang
medikal at kabilang ang mga Pasilidad ng may Kasanayang Pagkalinga na (Skilled Nursing
Facilities, SNF), Mga Pasilidad para sa Sub-Acute, at Mga Pasilidad na Intermediate Care.
Upang maghanap ng mga provider ng mga serbisyong ito, pumunta sa pahina
1323 sa Direktoryong ito.
Ang buong listahan ng mga serbisyong ito ay makikita sa Kabanata 4 ng iyong Handbook
ng Miyembro.
B4. Paano tukuyin ang mga provider sa network ng Blue Shield Promise Cal MediConnect
Plan
Dapat mong makuha ang lahat ng iyong nasasaklaw na serbisyo mula sa mga provider sa
loob ng aming network na kaanib sa medikal na pangkat ng iyong PCP. Kung pupunta ka
sa mga provider na wala sa network ng Blue Shield Promise Cal MediConnect Plan at hindi
kaanib sa medikal na pangkat ng iyong PCP (nang walang paunang awtorisasyon o pag-
apruba galing sa amin), ikaw ang magbabayad ng singilin.
Ang paunang awtorisasyon ay isang pag-apruba mula sa Blue Shield Promise Cal
MediConnect Plan bago ka makakuha ng partikular na serbisyo o gamot o mag-
patingin sa isang provider na wala sa network. Maaaring hindi saklawin ng Blue Shield
Promise Cal MediConnect Plan ang serbisyo o gamot kung hindi ka maaaprubahan.
Ang mga pagbubukod sa panuntunang ito ay kapag kailangan mo ng maagap o pang-
emergency na pangangalaga o dialysis at hindi makapunta sa isang provider sa plano,
gaya ng kapag wala ka sa iyong tahanan. Maaari ka ring lumabas sa plano o sa iyong
Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa
1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para
sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.
XII
medikal na pangkat ng PCP kung pahihintulutan ka muna ng Blue Shield Promise Cal
MediConnect Plan.
Maaari kang mangailangan ng referral upang magpatingin sa taong hindi Primary
Care Physician. Marami pang impormasyon tungkol sa mga referral sa Seksyon B1,
Mahahalagang termino, ng Direktoryong ito sa pahina IX.
• Maaari kang magpalit ng mga provider sa loob ng network anumang oras sa
buong taon. Kung pumupunta ka na sa isang provider sa network, hindi mo
kailangang magpatuloy sa parehong provider. Para sa ilang provider, maaari kang
mangailangan ng referral mula sa iyong PCP. Magkakaroon ng bisa ang pagpapalit
ng PCP sa unang araw ng susunod na buwan, sa kundisyon na matatanggap namin
ang iyong hiling bago ang ika-20 ng kasalukuyang buwan. Upang magpalit ng
iyong PCP, tawagan ang Customer Care. Kapag tumawag ka, siguruhing sabihin sa
Customer Care kung nagpapatingin ka sa isang espesyalista o kung nakakatanggap
ka ng iba pang nasasaklaw na serbisyo na nangangailangan ng pag-apruba ng
PCP (gaya ng mga serbisyo sa kalusugan sa tahanan at matibay na medikal na
kagamitan). Makakatulong ang Customer Care na matiyak na maipagpapatuloy
mo ang iyong pangangalaga ng espesyalista at iba pang serbisyo kapag nagpalit
ka ng iyong PCP. Titiyakin din ng Member Services kung ang ipapalit mong PCP ay
tumatanggap ng mga bagong pasyente. Babaguhin ng Member Services ang iyong
rekord sa pagiging miyembro upang ipakita ang pangalan ng bago mong PCP at
upang sabihin sa iyo kung kailan magkakaroon ng bisa ang pagpapalit mo ng PCP.
Magpapadala rin sa iyo ang Member Services ng bagong membership card kung
saan ipinapakita ang pangalan at numero ng telepono ng bago mong PCP.
• Tandaang kaanib ang mga PCP ng aming plano sa mga medikal na pangkat. Kung
nagpalit ka ng PCP, maaaring nagpalit ka rin ng medikal na pangkat. Kapag hinihiling
mo ang pagpapalit, tiyaking sabihin sa Member Services kung magpapatingin ka sa
espesyalista o kukuha ka ng iba pang nasasaklaw na serbisyong nangangailangan
ng pag-apruba ng PCP. Makakatulong ang Member Services na matiyak na
maipagpapatuloy mo ang iyong pangangalaga ng espesyalista at iba pang serbisyo
kapag nagpalit ka ng PCP.
• Nakikipagtulungan ang Blue Shield Promise Cal MediConnect Plan sa lahat ng
provider sa aming network upang maasikaso ang mga pangangailangan ng mga
taong may kapansanan. Kung naaangkop, kabilang sa listahan ng mga provider
sa network sa Direktoryong ito ang impormasyon tungkol sa mga pag-aasikasong
kanilang ibinibigay.
• Kung kailangan mong magpatingin sa isang provider at hindi ka sigurado kung
inaalok nila ang mga pag-aasikasong kailangan mo, matutulungan ka ng Blue Shield
Promise Cal MediConnect Plan. Makipag-usap sa iyong Care Navigator, para sa
tulong o tumawag sa Member Services sa 1-855-905-3825 (TTY:711) 8:00 a.m. to 8:00
p.m. seven days a week.
B5. Paano mahanap ang mga provider ng Blue Shield Promise Cal MediConnect Plan sa
inyong lugar
Parehong tinatanggap ng lahat ng provider na nakalista sa direktoryong ito ang Medicare
Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa
1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para
sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.
XIII
at Medi-Cal. Ang mga provider sa direktoryong ito ay nakaayos ayon sa alpabeto ayon sa
Medikal na Pangkat/IPA, pagkatapos ay ayon sa Primary Care Physician (PCPs) at nakalista
ayon sa alpabeto ayon sa apelyido sa bawat lungsod. Ang mga espesyalista ay nakalista
ayon sa uri ng espesyalidad at ayon sa lungsod. Sa pamamagitan ng paghahanap sa
lungsod kung saan ka nakatira, mahahanap mo ang mga doktor na nakalista sa iyong
lugar.
Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa
1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para
sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.
XIV
B6. Listahan ng mga provider sa network
Naglalaman ang direktoryong ito ng mga provider sa network ng Blue Shield Promise Cal
MediConnect Plan ng:
• Mga health care professional kabilang ang mga primary care physician, espesyalista
at mga provider para sa kalusugan ng pag-uugali at paningin
• Mga Pasilidad kabilang ang mga ospital, nursing facility, skilled nursing facility,
pasilidad ng kalusugan ng pag-iisip; at
• Mga provider ng suporta kabilang ang mga serbisyo sa mga nasa hustong gulang sa
araw, pamumuhay nang may tulong, serbisyong idinidirekta ng consumer, pagkaing
inihahatid sa tahanan at ahensya ng kalusugan sa tahanan.
Nakalista ang mga provider sa pagkakasunud-sunod na ayon sa alpabeto ayon sa
apelyido. Makikita mo rin ang pangalan ng provider at ang pahina kung saan naroon
ang karagdagang impormasyon ng pakikipag-ugnayan ng provider sa Indise sa dulo ng
Direktoryo. Nakalista rin ang mga provider sa pagkakasunud-sunod na ayon sa alpabeto
ayon sa apelyido sa Indise. Bilang karagdagan sa impormasyon ng pakikipag-ugnayan,
kabilang din sa listahan ng provider ang mga espesyalidad at kasanayan, halimbawa,
gaya ng mga wikang ginagamit o pagtatapos ng pagsasanay sa kakayahang pangkultura.
Ang pagsasanay sa kakayahang pangkultura ay karagdagang pagtuturo para sa
aming mga provider ng pangangalagang pangkalusugan na nakakatulong sa kanila
na mas mahusay na maunawaan ang iyong karanasan, mga pagpapahalaga at
mga paniniwala upang umangkop sa iyong mga pangangailangang panlipunan,
pangkultura at wika.
B7. Ang iyong Mga Karagdagang Benepisyo
Sinasaklaw ng iyong plan ang mga karagdagang benepisyo na kabilang ang paningin at
mga serbisyong acupuncture/chiropractic. Malamang na kakailanganin mong gumamit
ng mga partikular na provider para sa mga karagdagang benepisyong ito. Nakalista
ang mga provider sa direktoryong ito. Nakalista sa ibaba ang iba pang karagdagang
serbisyo. Bago ka gumawa ng isang appointment o gumamit ng mga serbisyo, tingnan
ang iyong Katibayan ng Saklaw (Evidence of Coverage) o tumawag sa Blue Shield Promise
Cal MediConnect Plan at 1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa
isang linggo para sa mga detalye tungkol sa mga benepisyo, limitasyon at pagbubukod ng
plano. Kung hindi kasama sa iyong plan ang mga karagdagang benepisyo at pumunta ka
sa isa sa mga provider na ito, HINDI masasaklaw ang mga serbisyo sa iyo.
Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa
1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para
sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.
XV
Mga Produktong Over-the Counter CVS
Ang mga ito ay mga produktong over- 1-888-628-2770 (TTY: 711)
the counter na hind saklaw ng Medicare Lunes hanggang Biyernes,
o Medi-Cal at hindi nakalista sa Tier 4 ng 9 a.m. and 5 p.m. (PT) aming Pormularyo.
Sistema ng Personal na Pagtugon sa
Emergency (PERS)
LifeStation
1-855-672-3269(TTY:711)
24 hours, 7 araw sa isang linggo
Pagiging miyembro Tivity
sa ftness
Silver Sneakers Kung miyembro ka o gustong malaman
Ang Tivity Health at SilverSneakers ay kung karapat-dapat ka:
mga nakarehistrong trademark o mga 888-423-4632, Lunes – Biyernes, 8 a.m. – 8
trademark ng Tivity Health, Inc., at/o mga p.m. EST.
subsidiary nito at/o mga kaanib na nasa USA [email protected]
at/o ibang bansa
Teladoc Maaari kang makipag-ugnay sa Teladoc sa
pamamagitan ng telepono sa 1-800-Teladoc
24/7 o sa pamamagitan ng ligtas na online
na video sawww.teladoc.com/bsc, mula 7
a.m. hanggang 9 p.m. lokal na Oras
Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa
1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para
sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.
XVI
C. Listahan ng network ng mga botika
Nagbibigay ang Direktoryo ng listahan ng mga botika sa network ng Blue Shield Promise
Cal MediConnect Plan. Ang mga botikang ito sa network ay mga botikang sumang-ayong
magbigay ng mga resetang gamot sa iyo bilang miyembro ng plano.
• Dapat gumamit ang mga miyembro ng Blue Shield Promise Cal MediConnect Plan ng
mga botika sa network upang makakuha ng mga resetang gamot..
○ Dapat kang gumamit ng mga botika sa network maliban sa mga sitwasyon na
emergency o maagap na pangangalaga. .
○ Kung pumunta ka sa isang botika sa labas ng network para sa mga resetang
gamot kung kailan hindi emergency, kailangan mong magbayad para sa
serbisyo. Basahin ang Blue Shield Promise Cal MediConnect Handbook ng
Miyembro para sa karagdagang impormasyon..
• Maaaring hindi nakalista ang ilang botika sa network sa Direktoryong ito.
○ May ilang parmasya sa network na maaaring nadagdag o naalis mula sa
aming plan pagkatapos ilathala ang Direktoryong ito.
Para sa napapanahong impormasyon tungkol sa mga botika sa network ng Blue
Shield Promise Cal MediConnect sa iyong lugar, pakibisita ang aming web site sa www.
blueshieldca.com/promise/calmediconnect o tumawag sa Member Services sa 1-855- 905-
3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag.
Upang makakuha ng kumpletong paglalarawan ng iyong nasasaklaw na reseta, kabilang
ang kung paano punan ang iyong mga reseta, pakibasa ang Handbook ng Miyembro at
Listahan ng Mga Saklaw na Gamot ng Blue Shield Promise Cal MediConnect. Makikita ang
listahan ng mga Gamot sa website sa www.blueshieldca.com/promise/calmediconnect o
maaaring mag-order sa pamamagitan ng pagtawag sa Member Services sa 1-855- 905-
3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo.
C1. Paano tukuyin ang mga botika sa network ng Blue Shield Promise Cal MediConnect
Plan
Kasama ng mga tingiang botika, kabilang sa network ng mga botika ng iyong plano ang:
• Nagpapadala ang mga botikang mail-order ng mga saklaw na resetang gamot sa
mga miyembro sa pamamagitan ng koreo o mga kompanya ng shipping.
• Naghahanda ang mga botikang pag-iiniksiyon sa tahanan (home infusion pharmacy)
ng mga resetang gamot na ibinibigay sa pamamagitan ng ugat, sa kalamnan, o sa
isa pang paraan na hindi sa bibig ng isang nagsanay na provider sa iyong tahanang.
• Naglilingkod ang mga botikang pangmatagalang pangangalaga (LTC) sa mga
residente ng mga pasilidad ng pangmatagalang pangangalaga, gaya ng mga
nursing home.
• Mga botika ng Indian Health Service / Tribal / Urban Indian Health Program (I/T/U).
Hindi mo kinakailangang magpatuloy na pumunta sa iisang parmasya upang punan
ang iyong mga reseta.
Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa
1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para
sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.
XVII
C2. Mga pangmatagalang supply ng mga reseta
• Mga Mail-Order na Programa. Nag-aalok kami ng mail order na programang
nagbibigay-daan sa iyong makakuha ng pang-90 araw na supply ng iyong mga
resetang gamot na direkta sa iyong tahanan. Pareho ang copay ng pang- 90 araw
na supply sa pang-isang buwang supply. Hindi available ang lahat ng gamot sa
karagdagang araw ng supply na ito. Mangyaring makipag-ugnayan sa plano para
sa higit pang impormasyon.
• Mga Programa ng Pang-90 Araw na Tingiang Botika. Maaari ding mag-alok ang ilang
tingiang botika ng hanggang pang-90 araw na supply ng nasasaklaw na resetang
gamot. Pareho ang copay ng pang-90 araw na supply sa pang-isang buwang
supply. Hindi available ang lahat ng gamot sa karagdagang araw ng supply na ito.
Mangyaring makipag-ugnayan sa plano para sa higit pang impormasyon
Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan sa
1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag. Para
sa karagdagang impormasyon, bumisita sa www.blueshieldca.com/promise/calmediconnect.
XVIII
Ang kabuuang network ng Blue Shield Promise Cal MediConnect Plan ay binubuo ng
sumusunod:
Kabuuang bilang ng mga PCP: 449
Kabuuang bilang ng mga espesyalista: 4327
Kabuuang bilang ng mga ospital: 18
Kabuuang bilang ng mga skilled nursing facility: 55
Kabuuang bilang ng mga nursing facility: 55
Kabuuang bilang ng mga provider ng pangmatagalang serbisyo at suporta: 1
Kabuuang bilang ng mga Tagapaglaan ng acupuncture: 659
Kabuuang bilang ng mga Pasilidad ng kalusugan ng pag-iisip: 90
Kabuuang bilang ng mga Tagapaglaan para sa kalusugan ng pag-iisip: 183
Kabuuang bilang ng mga serbisyo ng kalusugan sa tahanan: 27
Kabuuang bilang ng mga provider para sa paningin: 323
Kabuuang bilang ng mga provider para sa ngipin: 0
Kabuuang bilang ng mga tingian at malakihang botika: 441
Kabuuang bilang ng mga mail order na botika:1
Kabuuang bilang ng mga home infusion na botika: 4
KaKabuuang bilang ng mga botika para sa pangmatagalang pangangalaga: 29
Kabuuang bilang ng mga I/T/U na Botika: 4
Ang mga provider sa direktoryong ito ay nakaayos ayon sa alpabeto ayon sa medikal na
pangkat. Maaari kang makakuha ng mga serbisyo mula sa alinmang provider sa listahang
ito na kaanib sa medikal na pangkat ng iyong PCP. Para sa ilang serbisyo, maaari kang
mangailangan ng referral mula sa iyong PCP.
Kung mayroon kang mga tanong, pakitawagan ang Blue Shield Promise Cal MediConnect Plan
sa 1-855-905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m. pitong araw sa isang linggo. Libre ang tawag.
Para sa karagdagang impormasyon, bumisita sa
www.blueshieldca.com/promise/calmediconnect.
XIX
SAN DIEGO COUNTY MEDICAL GROUPS BLUE SHIELD PROMISE HEALTH PLAN DIRECT
SPECIALISTS
Members may not self-refer to
any of the specialists listed
below. To receive covered
services from a specialist you
must receive a referral from
your primary care physician.
Cardiology
ESCONDIDO
92029
Bayat, Hamed MD
1955 Citracado Pkwy Ste 300
Escondido, CA 92029
(760) 743-0546
License: A61356
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Cardiovascular Disease
CHULA VISTA
91910
Berman, Brett MD
321 E St Ste A
Chula Vista, CA 91910
(619) 934-3260
License: A78854
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Reddy, Reddiwandla MD
5565 Grossmont Center Dr Ste
202
La Mesa, CA 91942
(619) 461-6130
License: A38098
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Kannada,
Spanish, Telugu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Certified Nurse Practitioner
SAN MARCOS
92069
Palen, Barbara NP
150 Valpreda Rd
San Marcos, CA 92069
(760) 736-6767
License: NP3108
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 1
SAN DIEGO COUNTY MEDICAL GROUPS BLUE SHIELD PROMISE HEALTH PLAN DIRECT
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
VISTA
92083
Ayele, Mahogany NP
134 Grapevine Rd
Vista, CA 92083
(844) 308-5003
License: NP19570
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Estonian,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92084
Ayele, Mahogany NP
1000 Vale Terrace Dr
Vista, CA 92084
(760) 631-5000
License: NP19570
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Estonian,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Certified Registered Nurse
Midwife
ENCINITAS
92024
Karver Christenson, Elyse
1130 2nd St
Encinitas, CA 92024
(760) 943-9994
License: NMW276
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
OCEANSIDE
92054
Alston, Vickie CRNM
2210 Mesa Dr Ste 5
Oceanside, CA 92054
(760) 757-5841
License: NM993
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 2
SAN DIEGO COUNTY MEDICAL GROUPS BLUE SHIELD PROMISE HEALTH PLAN DIRECT
Dermatology
LA JOLLA
92037
Miremadi, Arjamg MD
7702 Ivanhoe Ave
La Jolla, CA 92037
(858) 456-1840
License: A31016
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Emergency Medicine
Kreshak, Allyson MD
9300 Campus Point Dr
La Jolla, CA 92037
(619) 543-6222
License: A102811
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Gastroenterology
CHULA VISTA
91910
Alayo, Erick MD
587 Third Ave
Chula Vista, CA 91910
(619) 382-3315
License: A107506
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Wiener, Gregory MD
353 Church Ave # A
Chula Vista, CA 91910
(619) 585-8883
License: A41749
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: French,
Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Wiener, Gregory MD
353 Church Ave Ste A
Chula Vista, CA 91910
(619) 585-8883
License: A41749
Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 3
SAN DIEGO COUNTY MEDICAL GROUPS BLUE SHIELD PROMISE HEALTH PLAN DIRECT
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Nephrology
Soltero, Ricardo MD
340 4th Ave Ste 4
Chula Vista, CA 91910
(619) 427-1144
License: A68995
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Steer, Dylan MD
9834 Genesee Ave Ste 312
La Jolla, CA 92037
(858) 558-8150
License: A65604
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92103
Baranski, Joel MD
4060 4th Ave Ste 220
San Diego, CA 92103
(619) 299-2350
License: G67559
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92123
Faravardeh, Arman MD
8010 Frost St Ste 510
San Diego, CA 92123
(858) 637-4800
License: A94375
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Swedish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 4
SAN DIEGO COUNTY MEDICAL GROUPS BLUE SHIELD PROMISE HEALTH PLAN DIRECT
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Obstetrics / Gynecology
NATIONAL CITY
91950
Del Rosario, Gelen MD
502 Euclid Ave Ste 300
National City, CA 91950
(619) 475-1261
License: A113471
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN MARCOS
92069
Pountney, Marlene MD
150 Valpreda Rd
San Marcos, CA 92069
(760) 736-6767
License: A93248
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Otolaryngology
SAN DIEGO
92117
Azer, Philip MD
3660 Clairemont Dr Ste 2
San Diego, CA 92117
(858) 270-8151
License: G13273
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Pathology
92103
Datnow, Brian MD
200 W Arbor Dr
San Diego, CA 92103
(619) 543-5764
License: A31095
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 5
SAN DIEGO COUNTY MEDICAL GROUPS BLUE SHIELD PROMISE HEALTH PLAN DIRECT
Parast, Mana MD
200 W Arbor Dr
San Diego, CA 92103
(800) 926-8273
License: A102496
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Powell, Henry MD
200 W Arbor Dr
San Diego, CA 92103
(619) 543-5764
License: A25597
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Pediatrics
LA MESA
91942
Clay, Corrie MD
8881 Fletcher Pkwy Ste 200
La Mesa, CA 91942
(619) 464-6434
License: A91977
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN MARCOS
92069
Posadas, Emerito MD
150 Valpreda Rd
San Marcos, CA 92069
(760) 736-6767
License: A48980
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN YSIDRO
92173
Herman, Andrea MD
4050 Beyer Blvd
San Ysidro, CA 92173
(619) 428-4463
License: A72721
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 6
SAN DIEGO COUNTY MEDICAL GROUPS BLUE SHIELD PROMISE HEALTH PLAN DIRECT
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
VISTA
92084
Rahimi, Nassrin MD
1000 Vale Terrace Dr
Vista, CA 92084
(760) 631-5000
License: A56214
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Farsi
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Physical Medicine /
Rehabilitation
CHULA VISTA
91910
Bullock, Andrew DO
344 F St Ste 100
Chula Vista, CA 91910
(619) 379-6579
License: 20A6842
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Fataleka, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Bullock, Andrew DO
15644 Pomerado Rd Ste 204
Poway, CA 92064
(619) 379-6579
License: 20A6842
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Farsi,
Fataleka, Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92101
Bullock, Andrew DO
1855 1st Ave Ste 200
San Diego, CA 92101
(619) 379-6579
License: 20A6842
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Farsi,
Fataleka, Spanish
Cultural Competency: NR
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 7
150
SAN DIEGO COUNTY MEDICAL GROUPS BLUE SHIELD PROMISE HEALTH PLAN DIRECT
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92128
Chong, Timothy MD
16466 Bernardo Center Dr Ste
San Diego, CA 92128
(858) 453-7700
License: A103353
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Physicians Assistant
CHULA VISTA
91910
Mercer, Kelly PA
760 Otay Lakes Rd
Chula Vista, CA 91910
(619) 821-2300
License: PA21625
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92104
Castillo, Patricia PA
3544 30th St
San Diego, CA 92104
(619) 515-2424
License: PA17220
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92111
Mercer, Kelly PA
5671 Balboa Ave
San Diego, CA 92111
(858) 800-2880
License: PA21625
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SANTEE
92071
Mercer, Kelly PA
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 8
100
SAN DIEGO COUNTY MEDICAL GROUPS BLUE SHIELD PROMISE HEALTH PLAN DIRECT
10538 Mission Gorge Rd Ste
Santee, CA 92071
(619) 456-0033
License: PA21625
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Podiatrist
CHULA VISTA
91910
Longobardi, James DPM
450 4th Ave Ste 401
Chula Vista, CA 91910
(619) 425-5500
License: DPM3675
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Pulmonary Diseases
ESCONDIDO
92025
Bender, Frank MD
488 E Valley Pkwy Ste 211
Escondido, CA 92025
(760) 489-1458
License: G33933
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rheumatology
SAN DIEGO
92108
Pazirandeh, Mahmood MD
3633 Camino Del Rio S Ste 300
San Diego, CA 92108
(619) 287-9730
License: C52328
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Russian, Spanish, Tagalog
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Surgery General
92111
Nguyen, Tri MD
7345 Linda Vista Rd Ste A
San Diego, CA 92111
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 9
SAN DIEGO COUNTY MEDICAL GROUPS BLUE SHIELD PROMISE HEALTH PLAN DIRECT
(858) 277-5463
License: G79496
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Chinese,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Surgery Neurological
Blaskiewicz, Donald MD
3750 Convoy St Ste 301
San Diego, CA 92111
(619) 297-4481
License: A109748
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92123
Soumekh, Massoud Hertzel MD
8008 Frost St Ste 401
San Diego, CA 92123
(858) 560-8544
License: A37843
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Surgery Orthopedic
POWAY
92064
Balikian, Philip MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3286
License: C52136
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Armenian,
Italian, Spanish, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Cohen, Brad MD
15611 Pomerado Rd Ste 525
Poway, CA 92064
(858) 485-0050
License: A62550
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 10
SAN DIEGO COUNTY MEDICAL GROUPS BLUE SHIELD PROMISE HEALTH PLAN DIRECT
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Urology
CORONADO
92118
Roberts, James MD
230 Prospect Pl Ste 300
Coronado, CA 92118
(619) 299-0670
License: G59945
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 11
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
AFFILIATED HOSPITALS
Above are hospitals you may
visit through this Medical
Group. For a complete listing
of hospital affiliations or to
access another hospital, refer
to page 1319. You will need to
coordinate with your PCP
and/or Medical Group. For
questions, call Blue Shield
Promise Cal MediConnect
Plan Customer Care.
PRIMARY CARE PHYSICIANS
Family Practice
CHULA VISTA
91910
Rawi, Bashir MD
256 Landis Ave Ste 202
Chula Vista, CA 91910
(619) 522-0399
Provider ID: 268578
License: A48140
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic,
Farsi, Spanish, Urdu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
91911
Elsayed, Mohammed MD
330 Oxford St Ste 106
Chula Vista, CA 91911
(619) 409-1802
Provider ID: 126786
License: A100765
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic,
German, Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rawi, Bashir MD
1323 3rd Ave
Chula Vista, CA 91911
(619) 409-6900
Provider ID: 127106
License: A48140
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic,
Farsi, Spanish, Urdu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
EL CAJON
92019
Korkis, Ebtissam MD
1530 Jamacha Rd Ste E-f
El Cajon, CA 92019
(619) 441-9200
Provider ID: 128349
License: A89767
Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 12
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
French, Kurdish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92020
Dominguez, Dennis MD
Contract terminated as of
8/31/2021
875 El Cajon Blvd
El Cajon, CA 92020
(619) 441-3550
Provider ID: 277659
License: G43179
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Delgado, George MD
362 W Mission Ave Ste 105
Escondido, CA 92025
(760) 741-1224
Provider ID: 238500
License: G66807
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Nguyen, Ngoc MD
488 E Valley Pkwy Ste 211
Escondido, CA 92025
(760) 294-2266
Provider ID: 274685
License: A74094
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Saroki, Karen MD
362 W Mission Ave Ste 105
Escondido, CA 92025
(760) 741-1224
Provider ID: 206815
License: A105032
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 13
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Baez, Beatrice MD
2743 Highland Ave
National City, CA 91950
(844) 200-2426
Provider ID: 238125
License: A74777
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mckennett, Marianne MD
2835 Highland Ave Ste B
National City, CA 91950
(844) 200-2426
Provider ID: 214139
License: G57243
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Palacios, Yelennia MD
2835 Highland Ave Ste A
National City, CA 91950
(619) 474-4451
Provider ID: 268973
License: A152662
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Special Expertise: HIV/AIDS
Serpas, Shaila MD
2835 Highland Ave
National City, CA 91950
(844) 800-2426
Provider ID: 215070
License: G74728
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 14
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Sevilla, Marianito MD
2340 E 8th St Ste D
National City, CA 91950
(619) 470-7007
Provider ID: 121762
License: A37097
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Tagalog
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Trimor-tamoria, Maria Flora
MD
2240 E Plaza Blvd Ste A
National City, CA 91950
(619) 267-5884
Provider ID: 128378
License: A55589
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Cornelius, Carol MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3210
Provider ID: 119138
License: G53676
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: German,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Ionescu, Ludmilla MD
15611 Pomerado Rd Fl 3
Poway, CA 92064
(858) 675-3210
Provider ID: 270004
License: C130451
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Russian
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Maletz, Louis MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3100
Provider ID: 119131
License: G50801
Credentials and/or board
certification: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 15
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: German,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Meram, Susan MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3100
Provider ID: 119136
License: A53727
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mir, Yusra MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3100
Provider ID: 119139
License: A101298
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Hindi,
Spanish, Urdu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Putnam, Richard MD
15611 Pomerado Rd Ste 300
Poway, CA 92064
(858) 675-3100
Provider ID: 270285
License: G50068
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
RAMONA
92065
Blando, Ellen MD
211 13th St
Ramona, CA 92065
(760) 789-5160
Provider ID: 119142
License: A65631
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 16
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
present. Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: German,
Dassoff, David MD Spanish
211 13th St Cultural Competency: NR
Ramona, CA 92065 Accessibility: B; Members
(760) 789-5160 should call the provider’s
Provider ID: 119125 office to discuss their
License: G137536 accessibility needs when there
Credentials and/or board is limited access or when
certification: No accessibility indicators are not
Accepting New Members: Yes present.
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish Miller, Jerry MD
Cultural Competency: NR 211 13th St
Accessibility: B; Members Ramona, CA 92065
should call the provider’s (760) 789-5160
office to discuss their Provider ID: 119127
accessibility needs when there License: A119340
is limited access or when Credentials and/or board
accessibility indicators are not certification: No
present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Kasch, Janine DO Other Language: Spanish
211 13th St Cultural Competency: NR
Ramona, CA 92065 Accessibility: B; Members
(760) 789-5160 should call the provider’s
Provider ID: 271735 office to discuss their
License: 20A5832 accessibility needs when there
Credentials and/or board is limited access or when
certification: No accessibility indicators are not
Accepting New Members: Yes present.
SAN DIEGO
92102
Rawi, Bashir MD
955 Gateway Center Way Ste
105
San Diego, CA 92102
(619) 264-1934
Provider ID: 268579
License: A48140
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Farsi, Spanish, Urdu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92105
Recalde, Francisco MD
3811 El Cajon Blvd
San Diego, CA 92105
(619) 284-5622
Provider ID: 128320
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 17
106
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
License: C41872
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92108
Delgado, George MD
5030 Camino De La Siesta Ste
San Diego, CA 92108
(619) 692-4401
Provider ID: 238499
License: G66807
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Saroki, Karen MD
5030 Camino De La Siesta Ste
106
San Diego, CA 92108
(619) 692-4401
Provider ID: 129342
License: A105032
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92111
Ahn, Edward MD
Contract terminated as of
8/31/2021
7750 Dagget St Ste 108
San Diego, CA 92111
(858) 571-1004
Provider ID: 271642
License: A38304
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Korean
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92115
Le, Tram MD
5507 El Cajon Blvd # L
San Diego, CA 92115
(619) 286-2789
Provider ID: 129203
License: A105829
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 18
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
PTA: Yes present. certification: No
Other Language: Spanish,
Vietnamese
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92129
Blando, Ellen MD
9878 Carmel Mountain Rd Ste
B
San Diego, CA 92129
(858) 312-1440
Provider ID: 270143
License: A65631
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
92131
Nuqui, Josie MD
9855 Erma Rd Ste 105
San Diego, CA 92131
(844) 200-2426
Provider ID: 215006
License: A71544
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92154
Villa, Maria MD
655 Saturn Blvd Ste J
San Diego, CA 92154
(619) 575-4442
Provider ID: 122410
License: A86224
Credentials and/or board
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
VISTA
92083
Carrio, Kelsey MD
134 Grapevine Rd
Vista, CA 92083
(760) 631-5000
Provider ID: 273483
License: A158602
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 19
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
General Practice
CHULA VISTA
91911
Toledo, Abel MD
330 Oxford St Ste 110
Chula Vista, CA 91911
(619) 427-3118
Provider ID: 121721
License: A67360
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Italian,
Portuguese, Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Lopez, Irma MD
1035 E Grand Ave Ste 101
Escondido, CA 92025
(760) 480-4747
Provider ID: 207280
License: G57022
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Watson, Thomas MD
301 E Washington Ave Ste B
Escondido, CA 92025
(760) 480-9051
Provider ID: 121566
License: A52193
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Watson, Thomas MD
303 S Juniper St
Escondido, CA 92025
(760) 480-9051
Provider ID: 224918
License: A52193
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 20
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
(619) 445-6200 PTA: No92115
Dwabe, Kefah MD
4863 El Cajon Blvd # A
San Diego, CA 92115
(619) 286-9000
Provider ID: 121673
License: A94193
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic,
Burmese, Cambodian, Thai
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Internal Medicine
ALPINE
91901
Kellawon, Joyce MD
Contract terminated as of
7/31/2021
1620 Alpine Blvd
Alpine, CA 91901
Provider ID: 245003
License: C54522
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Korean, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CAMPO
91906
Kellawon, Joyce MD
Contract terminated as of
7/31/2021
1388 Buckman Springs Rd
Campo, CA 91906
(619) 445-6200
Provider ID: 245004
License: C54522
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
Other Language: Arabic,
Korean, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CHULA VISTA
91910
Espinosa-melendez, Enrique
MD
480 4th Ave Ste 507
Chula Vista, CA 91910
(619) 477-7779
Provider ID: 121742
License: C42745
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
Portuguese, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 21
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
is limited access or when
accessibility indicators are not
present.
Flores, Rocio MD
296 H St Ste 201
Chula Vista, CA 91910
(619) 271-5551
Provider ID: 258897
License: A69424
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Fadhil, Ali MD
340 Fourth Ave Ste 9
Chula Vista, CA 91910
(619) 426-9731
Provider ID: 268952
License: A145663
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
91911
De La Rosa, Renato MD
754 Medical Center Ct Ste 103
Chula Vista, CA 91911
(619) 397-5001
Provider ID: 121769
License: A65330
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
EL CAJON
92019
Reddy, Arjun MD
5442 Sycuan Rd
El Cajon, CA 92019
(619) 445-0707
Provider ID: 129312
License: A61204
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92020
Elias, Ramiz MD
231 W Main St
El Cajon, CA 92020
(858) 384-6857
Provider ID: 272654
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 22
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
License: A99956 office to discuss their
Credentials and/or board accessibility needs when there
certification: No is limited access or when
Accepting New Members: Yes accessibility indicators are not
Hours: M-SA 9AM-5PM present.
PTA: No
Other Language: Arabic, 92021 Farsi, Spanish
Cultural Competency: NR Toulouie, Elahe MD
Accessibility: B; Members Contract terminated as of
should call the provider’s 8/31/2021
office to discuss their 1580 N 2nd St
accessibility needs when there El Cajon, CA 92021
is limited access or when (619) 447-2425
accessibility indicators are not Provider ID: 269054
present. License: A73141
Credentials and/or board
certification: No
Jahanpanah, Fereshteh MD Accepting New Members: No
343 E Main St Ste 101 Hours: M-SA 9AM-5PM
El Cajon, CA 92020 PTA: No
(619) 447-6001 Other Language: Armenian,
Provider ID: 252339 Farsi, German
License: G65104 Cultural Competency: NR
Credentials and/or board Accessibility: B; Members
certification: No should call the provider’s
Accepting New Members: Yes office to discuss their
Hours: M-SA 9AM-5PM accessibility needs when there
PTA: No is limited access or when
Other Language: Arabic, accessibility indicators are not
Faroese, Farsi, Spanish present.
Cultural Competency: NR
Accessibility: B; Members ESCONDIDOshould call the provider’s
92025
Mashayekhi, Pegah DO
488 E Valley Pkwy Ste 211
Escondido, CA 92025
(760) 294-2266
Provider ID: 269119
License: 20A12987
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Shapiro, Mark MD
Contract terminated as of
8/31/2021
631 E Grand Ave
Escondido, CA 92025
(760) 294-1660
Provider ID: 275625
License: G65280
Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 23
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Swahili
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Prabaker, Venugopal MD
7339 El Cajon Blvd Ste I
La Mesa, CA 91942
(619) 698-0606
Provider ID: 123698
License: A42653
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic,
Chinese, Polish, Russian,
Spanish, Tagalog, Tamil, Thai
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Toulouie, Elahe MD
Contract terminated as of
8/31/2021
5358 Jackson Dr # 1
La Mesa, CA 91942
(619) 993-8996
Provider ID: 269053
License: A73141
Credentials and/or board
certification: Yes
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Armenian,
Farsi, German
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Altavas, Valerie MD
655 Euclid Ave Ste 209
National City, CA 91950
(619) 470-7000
Provider ID: 121740
License: C52243
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sacamay, Elena Maria MD
655 Euclid Ave Ste 209
National City, CA 91950
(619) 470-7000
Provider ID: 121747
License: A63422
Credentials and/or board
certification: No
Accepting New Members: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 24
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish,
Tagalog, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Carty, David MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3293
Provider ID: 119124
License: A41501
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dure-smith, Belinda MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3293
Provider ID: 119129
License: A52257
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mamaril, Dennis MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3293
Provider ID: 119126
License: A90180
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Presant, Larry MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3100
Provider ID: 119128
License: G42579
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 25
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
SAN DIEGO
92101
Lichtenstein, Bernard MD
250 Market St
San Diego, CA 92101
(619) 236-0111
Provider ID: 271039
License: A37396
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: German,
Hebrew, Polish, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Quinonez, Jose MD
250 Market St
San Diego, CA 92101
(619) 239-9675
Provider ID: 121499
License: A44257
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92102
Kellawon, Joyce MD
Contract terminated as of
7/31/2021
316 25th St
San Diego, CA 92102
(619) 445-6200
Provider ID: 245005
License: C54522
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Korean, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Nanduri, Ramachander MD
995 Gateway Center Way Ste
202
San Diego, CA 92102
(619) 264-3107
Provider ID: 127124
License: C50916
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Hindi,
Kannada, Spanish, Tamil,
Telugu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92111
Nguyen, Tri MD
7345 Linda Vista Rd Ste A
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 26
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
San Diego, CA 92111
(858) 277-5463
Provider ID: 121932
License: G79496
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Chinese,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92115
Kellawon, Joyce MD
Contract terminated as of
7/31/2021
4690 El Cajon Blvd
San Diego, CA 92115
(619) 445-6200
Provider ID: 245006
License: C54522
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Korean, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Le, Charles MD
4440 Euclid Ave Ste A
San Diego, CA 92115
(619) 521-6812
Provider ID: 127992
License: A124891
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Nguyen, Tri MD
4206 44th St
San Diego, CA 92115
(361) 962-4943
Provider ID: 270970
License: G79496
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Chinese,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Nguyen, Tue MD
4551 El Cajon Blvd
San Diego, CA 92115
(619) 280-7185
Provider ID: 270714
License: A49831
Credentials and/or board
certification: No
Accepting New Members: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 27
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Vietnamese
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Truong, Tu MD
5069 El Cajon Blvd
San Diego, CA 92115
(619) 583-8705
Provider ID: 129346
License: A50756
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Cambodian,
Spanish, Vietnamese
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Vo, Sony MD
4551 El Cajon Blvd
San Diego, CA 92115
(619) 280-7185
Provider ID: 128372
License: A49788
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92123
Elias, Ramiz MD
7695 Cardinal Ct Ste 375
San Diego, CA 92123
(858) 384-7072
Provider ID: 129397
License: A99956
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Farsi, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Shapiro, Mark MD
Contract terminated as of
8/31/2021
9610 Granite Ridge Dr Ste B
San Diego, CA 92123
(858) 810-8000
Provider ID: 270972
License: G65280
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Swahili
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 28
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
is limited access or when
accessibility indicators are not
present.
92126
Fabella, Gabriel MD
10737 Camino Ruiz Ste 115
San Diego, CA 92126
(858) 695-1262
Provider ID: 121666
License: A48087
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Japanese,
Spanish, Tagalog
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92139
Daramola, Iyabo MD
2401 Reo Dr
San Diego, CA 92139
(619) 479-6767
Provider ID: 247461
License: A63633
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92154
De Carvalho, Carlos MD
2939 Beyer Blvd
San Diego, CA 92154
(619) 423-0343
Provider ID: 259918
License: A38504
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Portuguese,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SPECIALISTS
Members may not self-refer to
any of the specialists listed
below. To receive covered
services from a specialist you
must receive a referral from
your primary care physician.
Allergy Immunology
LA MESA
91942
Reddy, Sumana MD
8860 Center Dr Ste 320
La Mesa, CA 91942
(619) 377-6565
Provider ID: 82087
License: C52581
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 29
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Other Language: Hindi,
Spanish, Telugu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92120
Reddy, Sumana MD
6699 Alvarado Rd Ste 2301
San Diego, CA 92120
(619) 588-4074
Provider ID: 65617
License: C52581
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Hindi,
Spanish, Telugu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SANTEE
92071
Reddy, Sumana MD
9456 Cuyamaca St Ste 102
Santee, CA 92071
(619) 377-6565
Provider ID: 69230
License: C52581
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Hindi,
Spanish, Telugu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
VISTA
92083
Ziering, Robert MD
2067 W Vista Way Ste 140
Vista, CA 92083
(760) 941-4444
Provider ID: 269520
License: A30813
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Anesthesiology Critical Care
Medicine
CHULA VISTA
91914
Macchio, Gregory MD
2452 Fenton St Ste C101
Chula Vista, CA 91914
(619) 600-5309
Provider ID: 268814
License: G88576
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 30
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Macchio, Gregory MD
2452 Fenton St Ste C203
Chula Vista, CA 91914
(619) 600-5309
Provider ID: 268815
License: G88576
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Anesthesiology Pain
Management
CARLSBAD
92011
Truong, Ngoc DO
6010 Hidden Valley Rd Ste 110
Carlsbad, CA 92011
(760) 607-5350
Provider ID: 277809
License: 20A13556
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Special Expertise: HIV/AIDS
CHULA VISTA
91910
Fisher, Casey MD
374 H St Ste 103
Chula Vista, CA 91910
(619) 625-1144
Provider ID: 204415
License: A118592
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
91914
Navarro, Rosa MD
2452 Fenton St # C101
Chula Vista, CA 91914
(619) 600-5309
Provider ID: 268792
License: C53858
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 31
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Navarro, Rosa MD
2452 Fenton St Ste C203
Chula Vista, CA 91914
(619) 600-5309
Provider ID: 268793
License: C53858
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Verdolin, Michael MD
2452 Fenton St Ste 205
Chula Vista, CA 91914
(619) 625-1144
Provider ID: 257923
License: A92149
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Italian,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ENCINITAS
92024
Fisher, Casey MD
326 Encinitas Blvd Ste 100
Encinitas, CA 92024
(619) 825-8511
Provider ID: 269185
License: A118592
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92029
Cohen, Zachary MD
2185 Citracado Pkwy
Escondido, CA 92029
(442) 281-5000
Provider ID: 268178
License: A146733
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 32
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
91942
Fisher, Casey MD
7051 Alvarado Rd Ste 101
La Mesa, CA 91942
(619) 625-1144
Provider ID: 204414
License: A118592
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Verdolin, Michael MD
7051 Alvarado Rd Ste 101
La Mesa, CA 91942
(619) 625-1144
Provider ID: 203328
License: A92149
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Italian,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Wynn, Brenton MD
502 Euclid Ave Ste 200
National City, CA 91950
(619) 434-4019
Provider ID: 268987
License: A73257
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
OCEANSIDE
92056
Fisher, Casey MD
3142 Vista Way Ste 207
Oceanside, CA 92056
(760) 610-0522
Provider ID: 269184
License: A118592
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Cohen, Zachary MD
15611 Pomerado Rd Ste 505
Poway, CA 92064
(760) 631-3000
Provider ID: 268179
License: A146733
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 33
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Fisher, Casey MD
15725 Pomerado Rd Ste 218
Poway, CA 92064
(619) 825-8511
Provider ID: 204416
License: A118592
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Verdolin, Michael MD
15725 Pomerado Rd Ste 218
Poway, CA 92064
(619) 825-8511
Provider ID: 203330
License: A92149
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Italian,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Anesthesiology
ESCONDIDO
92025
Khatibi, Nikan DO
430 N Cedar St Ste D
Escondido, CA 92025
(888) 873-6220
Provider ID: 118688
License: 20A11914
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Khatibi, Nikan DO
160 N Date St
Escondido, CA 92025
(888) 873-6220
Provider ID: 239611
License: 20A11914
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 34
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Audiologist
Herrera, Charity MA
330 W Felicita Ave Ste A4
Escondido, CA 92025
(760) 489-1323
Provider ID: 269239
License: AU2110
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92123
Herrera, Charity MA
9340 Clairemont Mesa Blvd Ste
D
San Diego, CA 92123
(858) 278-9911
Provider ID: 269240
License: AU2110
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Cardiac Electrophysiology
OCEANSIDE
92056
Bui, Hanh MD
3909 Waring Rd Ste A
Oceanside, CA 92056
(760) 630-2550
Provider ID: 269408
License: A79185
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Chinese,
Spanish, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Cardiology
CHULA VISTA
91910
Berman, Brett MD
321 E St Ste A
Chula Vista, CA 91910
(619) 934-3260
Provider ID: 268466
License: A78854
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 35
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Kafri, Hassan MD
429 Broadway
Chula Vista, CA 91910
(619) 434-0204
Provider ID: 265196
License: A96002
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Farsi, German, Russian,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Ponce, Sonia MD
450 Fourth Ave Ste 215
Chula Vista, CA 91910
(619) 434-0204
Provider ID: 268702 should call the provider’s
License: A145008 office to discuss their
Credentials and/or board accessibility needs when there
certification: No is limited access or when
Accepting New Members: Yes accessibility indicators are not
Hours: M-SA 9AM-5PM
PTA: No
present.
Other Language: Spanish
Cultural Competency: NR Mohamedali, Burhan MD
Accessibility: B; Members 765 Medical Center Ct Ste 211
should call the provider’s Chula Vista, CA 91911
office to discuss their (619) 616-2100
accessibility needs when there Provider ID: 245576
is limited access or when License: A125669
accessibility indicators are not Credentials and/or board
present. certification: No
Accepting New Members: Yes
91911 Hours: M-SA 9AM-5PM
PTA: No
Moussavian, Mehran DO Other Language: Spanish,
765 Medical Center Ct Ste 211 Swahili
Chula Vista, CA 91911 Cultural Competency: NR
(619) 616-2100 Accessibility: B; Members
Provider ID: 242263 should call the provider’s
License: 20A7241 office to discuss their
Credentials and/or board accessibility needs when there
certification: No is limited access or when
Accepting New Members: Yes accessibility indicators are not
Hours: M-SA 9AM-5PM present.
PTA: No
Other Language: Farsi,
Spanish Naghi, Jesse MD
Cultural Competency: NR 752 Medical Center Ct Ste 207
Accessibility: B; Members Chula Vista, CA 91911
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 36
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
(619) 867-0557 Accessibility: B; Members (619) 597-1341
Provider ID: 247625 should call the provider’s Provider ID: 268950
License: A110094 office to discuss their License: A70917
Credentials and/or board accessibility needs when there Credentials and/or board
certification: No is limited access or when certification: No
Accepting New Members: Yes accessibility indicators are not Accepting New Members: Yes
Hours: M-SA 9AM-5PM present. Hours: M-SA 9AM-5PM
PTA: No PTA: No
Other Language: Arabic, Other Language: Bulgarian,
Bulgarian, Russian, Spanish, Rutledge, Michael MD Malayalam, Russian, Spanish
Tagalog 751 Medical Center Ct Cultural Competency: NR
Cultural Competency: NR Chula Vista, CA 91911 Accessibility: B; Members
Accessibility: B; Members (619) 502-5851 should call the provider’s
should call the provider’s Provider ID: 268763 office to discuss their
office to discuss their License: C166106 accessibility needs when there
accessibility needs when there Credentials and/or board is limited access or when
is limited access or when certification: No accessibility indicators are not
accessibility indicators are not Accepting New Members: Yes present.
present. Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish Shetabi, Kambiz MD
Parikh, Milind DO Cultural Competency: NR 765 Medical Center Ct Ste 211
765 Medical Center Ct Ste 211 Accessibility: B; Members Chula Vista, CA 91911
Chula Vista, CA 91911 should call the provider’s (619) 616-2100
(619) 616-2100 office to discuss their Provider ID: 268772
Provider ID: 268745 accessibility needs when there License: A126187
License: 20A13745 is limited access or when Credentials and/or board
Credentials and/or board accessibility indicators are not certification: No
certification: Yes present. Accepting New Members: Yes
Accepting New Members: Yes Hours: M-SA 9AM-5PM
Hours: M-SA 9AM-5PM PTA: No
PTA: No Sherev, Dimitri MD Other Language: Spanish
Other Language: Spanish 752 Medical Center Ct Ste 207 Cultural Competency: NR
Cultural Competency: NR Chula Vista, CA 91911 Accessibility: B; Members
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 37
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
91914
Cepin, Daniel MD
890 Eastlake Pkwy Ste 205
Chula Vista, CA 91914
(619) 482-0300
Provider ID: 268781
License: G52521
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
EL CAJON
92020
Kafri, Hassan MD
328 Highland Ave Ste 200
El Cajon, CA 92020
(619) 930-9404
Provider ID: 209019
License: A96002
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Farsi, German, Russian,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Ponce, Sonia MD
328 Highland Ave Ste 200
El Cajon, CA 92020
(619) 930-9404
Provider ID: 268703
License: A145008
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92021
Sharf, Albert MD
1240 Broadway Ste 210
El Cajon, CA 92021
(619) 470-7700
Provider ID: 269167
License: G72122
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 38
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
92029
Bayat, Hamed MD
1955 Citracado Pkwy Ste 300
Escondido, CA 92029
(760) 743-0546
Provider ID: 53687
License: A61356
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Gilbert, Christopher MD
1955 Citracado Pkwy Ste 300
Escondido, CA 92029
(760) 743-0546
Provider ID: 63549
License: A35403
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Gorwit, Jeffrey MD
1955 Citracado Pkwy Ste 300
Escondido, CA 92029
(760) 743-0546
Provider ID: 63540
License: G25365
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sawhney, Navinder MD
1955 Citracado Pkwy Ste 300
Escondido, CA 92029
(760) 743-0546
Provider ID: 112701
License: A86378
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Serry, Rod MD
1955 Citracado Pkwy Ste 300
Escondido, CA 92029
(760) 743-0546
Provider ID: 54469
License: A76061
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Portuguese, Spanish
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 39
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Naghi, Jesse MD
8851 Center Dr Ste 304
La Mesa, CA 91942
(619) 867-0557
Provider ID: 119543
License: A110094
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Bulgarian, Russian, Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sherev, Dimitri MD
8851 Center Dr Ste 304
La Mesa, CA 91942
(619) 867-0557
Provider ID: 65688
License: A70917
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Bulgarian,
Malayalam, Russian, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Yellen, Laurence MD
8851 Center Dr Ste 405
La Mesa, CA 91942
(619) 582-2404
Provider ID: 269173
License: G15453
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Camacho, Benjamin MD
1615 Sweetwater Rd
National City, CA 91950
(619) 474-2233
Provider ID: 269129
License: A52660
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Tagalog
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 40
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
present. Accepting New Members: Yes accessibility indicators are not
Hours: M-SA 9AM-5PM present.
PTA: Yes
Dubey, Rajesh MD Other Language: Bulgarian,
610 Euclid Ave Ste 302 Russian, Spanish Nanavati, Vimal MD
National City, CA 91950 Cultural Competency: NR 2345 E 8th St Ste 111
(209) 521-9661 Accessibility: B, W; Members National City, CA 91950
Provider ID: 269343 should call the provider’s (619) 585-0476
License: A83527 office to discuss their Provider ID: 269553
Credentials and/or board accessibility needs when there License: G83522
certification: No is limited access or when Credentials and/or board
Accepting New Members: Yes accessibility indicators are not certification: No
Hours: M-SA 9AM-5PM present. Accepting New Members: Yes
PTA: No Hours: M-SA 9AM-5PM
Other Language: Bengali, PTA: No
Hindi, Spanish Fernandez, Genaro MD Cultural Competency: NR
Cultural Competency: NR 610 Euclid Ave Ste 201 Accessibility: B; Members
Accessibility: B; Members National City, CA 91950 should call the provider’s
should call the provider’s (619) 267-8181 office to discuss their
office to discuss their Provider ID: 268889 accessibility needs when there
accessibility needs when there License: A122302 is limited access or when
is limited access or when Credentials and/or board accessibility indicators are not
accessibility indicators are not certification: No present.
present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No Oviedo-linares, Raul MD
Fernandez, Genaro MD Other Language: French, 502 Euclid Ave Ste 104
610 Euclid Ave Ste 201 Italian, Spanish National City, CA 91950
National City, CA 91950 Cultural Competency: NR (619) 434-4288
(619) 267-8181 Accessibility: B; Members Provider ID: 269140
Provider ID: 121669 should call the provider’s License: A76050
License: A45754 office to discuss their Credentials and/or board
Credentials and/or board accessibility needs when there certification: No
certification: No is limited access or when Accepting New Members: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 41
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Polish,
Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Pandhi, Jay MD
655 Euclid Ave Ste 208
National City, CA 91950
(619) 512-1915
Provider ID: 269087
License: C56015
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rough, Steven MD
1615 Sweetwater Rd Ste D
National City, CA 91950
(619) 474-2233
Provider ID: 269349
License: A124001
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rough, Steven MD
502 Euclid Ave Ste 104
National City, CA 91950
(619) 434-4288
Provider ID: 269350
License: A124001
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Bayat, Hamed MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 592-2696
Provider ID: 269450
License: A61356
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 42
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Balouch, Maryam MD
15615 Pomerado Rd
Poway, CA 92064
(760) 743-0546
Provider ID: 269384
License: A121988
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mulvihill, Daniel MD
15611 Pomerado Rd Ste 580
Poway, CA 92064
(858) 592-2696
Provider ID: 54301
License: G55384
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Serry, Rod MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3100
Provider ID: 269471
License: A76061
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Portuguese, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Vanichsarn, Christopher MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 592-2696
Provider ID: 274775
License: A129210
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92111
Nguyen, Tri MD
7345 Linda Vista Rd Ste A
San Diego, CA 92111
(858) 277-5463
Provider ID: 121932
License: G79496
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 43
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Other Language: Chinese,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92114
Moussavian, Mehran DO
292 Euclid Ave Ste 210
San Diego, CA 92114
(619) 616-2100
Provider ID: 242264
License: 20A7241
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
Mohamedali, Burhan MD PTA: No
292 Euclid Ave Ste 210
San Diego, CA 92114
(619) 616-2100
Provider ID: 245577
License: A125669
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
Credentials and/or board
certification: No
accessibility needs when there
is limited access or when
Accepting New Members: Yes accessibility indicators are not
Hours: M-SA 9AM-5PM
PTA: No
present.
Other Language: Spanish,
Swahili
Cultural Competency: NR
Nguyen, Tri MD
4206 44th St
Accessibility: B; Members
should call the provider’s
office to discuss their
San Diego, CA 92115
(361) 962-4943
Provider ID: 270970
accessibility needs when there License: G79496
is limited access or when
accessibility indicators are not
Credentials and/or board
certification: No
present. Accepting New Members: No
Hours: M-SA 9AM-5PM
92115
Gollapudi, Raghava MD
6402 El Cajon Blvd # 102
San Diego, CA 92115
(858) 499-1900
Provider ID: 270061
PTA: Yes
Other Language: Chinese,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
License: A73392
Credentials and/or board
certification: No
accessibility needs when there
is limited access or when
accessibility indicators are not
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 44
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
present.
Sharf, Albert MD
4444 El Cajon Blvd Ste 2
San Diego, CA 92115
(619) 470-7700
Provider ID: 246500
License: G72122
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92123
Gollapudi, Raghava MD
7901 Frost St
San Diego, CA 92123
(858) 499-1900
Provider ID: 270060
License: A73392
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN MARCOS
92078
Moussavian, Mehran DO
955 Boardwalk Ste 100
San Marcos, CA 92078
(619) 616-2100
Provider ID: 242265
License: 20A7241
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mohamedali, Burhan MD
955 Boardwalk Ste 100
San Marcos, CA 92078
(760) 798-8855
Provider ID: 245578
License: A125669
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Swahili
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
VISTA
92083
Kabra, Ashish MD
2067 W Vista Way Ste 225
Vista, CA 92083
(760) 630-2550
Provider ID: 271714
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 45
115
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
License: A122620
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Cardiovascular Disease
LA MESA
91942
Boghairi, Anoushiravan MD
5565 Grossmont Center Dr Ste
La Mesa, CA 91942
(619) 698-6667
Provider ID: 269055
License: A33832
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Persian
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Kotha, Purushotham MD
8860 Center Dr Ste 400
La Mesa, CA 91942
(619) 229-1995
Provider ID: 32053
License: A41538
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Hindi,
Spanish, Telugu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Zakov, Kamen MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 592-2696
Provider ID: 122539
License: G31706
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Certified Acupuncturist
ALPINE
91901
Vuong, Long LAC
1620 Alpine Blvd Ste 110
Alpine, CA 91901
(619) 320-3343
Provider ID: 245211
License: AC17785
Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 46
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Chinese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Seitz, Gretchen LAC
2835 Highland Ave Ste B
National City, CA 91950
(844) 200-2426
Provider ID: 246472
License: AC8597
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Seitz, Gretchen LAC
2743 Highland Ave
National City, CA 91950
(844) 200-2426
Provider ID: 246475
License: AC8597
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92103
Seitz, Gretchen LAC
3320 2nd Ave
San Diego, CA 92103
(619) 302-6846
Provider ID: 246470
License: AC8597
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92126
Seitz, Gretchen LAC
10737 Camino Ruiz Ste 235
San Diego, CA 92126
(844) 200-2426
Provider ID: 246471
License: AC8597
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 47
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
accessibility needs when there Provider ID: 246473 Accessibility: B; Members
is limited access or when License: AC8597 should call the provider’s
accessibility indicators are not Credentials and/or board office to discuss their
present. certification: No accessibility needs when there
Accepting New Members: Yes is limited access or when
Hours: M-SA 9AM-5PM accessibility indicators are not92129 PTA: No present.
Seitz, Gretchen LAC Other Language: Spanish
9995 Carmel Mountain Rd # Cultural Competency: NR
B10-b11 Accessibility: B; Members
San Diego, CA 92129 should call the provider’s
(844) 200-2426 office to discuss their
CAMPO
91906
Nace, Michael NPProvider ID: 246474 accessibility needs when there 1388 Buckman Springs RdLicense: AC8597 is limited access or when Campo, CA 91906Credentials and/or board accessibility indicators are not (619) 445-6200certification: No present. Provider ID: 240032Accepting New Members: Yes License: NP11492Hours: M-SA 9AM-5PM Credentials and/or boardPTA: No certification: NoOther Language: Spanish Accepting New Members: YesCultural Competency: NR Hours: M-SA 9AM-5PMAccessibility: B; Members PTA: Noshould call the provider’s
Nace, Michael NP Cultural Competency: NR
Certified Nurse Practitioner
ALPINE
91901
office to discuss their 1620 Alpine Blvd Ste 110 Accessibility: B; Members accessibility needs when there Alpine, CA 91901 should call the provider’sis limited access or when (619) 445-6200 office to discuss theiraccessibility indicators are not Provider ID: 240033 accessibility needs when therepresent. License: NP11492 is limited access or when
Credentials and/or board accessibility indicators are not92131
certification: No present.
Accepting New Members: YesSeitz, Gretchen LAC Hours: M-SA 9AM-5PM9855 Erma Rd Ste 105 CARLSBAD PTA: NoSan Diego, CA 92131 Cultural Competency: NR(844) 200-2426
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 48
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
92011
Bierman, Andrew NP
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 247291
License: NP95011909
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Bishop, Leslie NP
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 243217
License: NP95010047
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Binavi, Hownaz NP
6010 Hidden Valley Rd Ste 120
Carlsbad, CA 92011
(760) 884-5990
Provider ID: 265369
License: NP95010956
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Kurdish,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hooper, Bonnie NP
6010 Hidden Valley Rd Ste 120
Carlsbad, CA 92011
(760) 884-5990
Provider ID: 275252
License: NP6495
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CHULA VISTA
91910
Carapia, Fabiola NP
340 4th Ave Ste 4
Chula Vista, CA 91910
(619) 427-1144
Provider ID: 268543
License: RN603937
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 49
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Accessibility: B; Members (619) 421-3361 is limited access or when
should call the provider’s Provider ID: 268746 accessibility indicators are not
office to discuss their License: NP95008069 present.
accessibility needs when there Credentials and/or board
is limited access or when certification: No
accessibility indicators are not Accepting New Members: Yes De Roldan, Sandra NP
present. Hours: M-SA 9AM-5PM 752 Medical Center Ct Ste 210
PTA: No Chula Vista, CA 91911
Cultural Competency: NR (619) 656-0206
Carapia, Fabiola NP Accessibility: B; Members Provider ID: 269290
340 4th Ave Ste 4 should call the provider’s License: NP22506
Chula Vista, CA 91910 office to discuss their Credentials and/or board
(619) 427-1144 accessibility needs when there certification: No
Provider ID: 268543 is limited access or when Accepting New Members: Yes
License: NP20855 accessibility indicators are not Hours: M-SA 9AM-5PM
Credentials and/or board present. PTA: No
certification: No Cultural Competency: NR
Accepting New Members: Yes Accessibility: B; Members
Hours: M-SA 9AM-5PM Buenrostro, Christina NP should call the provider’s
PTA: Yes 765 Medical Center Ct Ste 209 office to discuss their
Cultural Competency: NR Chula Vista, CA 91911 accessibility needs when there
Accessibility: B; Members (619) 427-8892 is limited access or when
should call the provider’s Provider ID: 269282 accessibility indicators are not
office to discuss their License: NP95004366 present.
accessibility needs when there Credentials and/or board
is limited access or when certification: No
accessibility indicators are not Accepting New Members: Yes Gil, Anna NP
present. Hours: M-SA 9AM-5PM 752 Medical Center Ct Ste 302
PTA: No Chula Vista, CA 91911
91911 Cultural Competency: NR
Accessibility: B; Members
(858) 810-8000
Provider ID: 268794
Akins, Melanie NP should call the provider’s License: NP95004447
752 Medical Center Ct Ste 302 office to discuss their Credentials and/or board
Chula Vista, CA 91911 accessibility needs when there certification: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 50
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
EL CAJON
92020
Brannen, Mandy NP
215 W Madison Ave
El Cajon, CA 92020
(619) 401-6236
Provider ID: 241600
License: NP95007286
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Chudacek, Janet NP
215 W Madison Ave
El Cajon, CA 92020
(760) 737-6960
Provider ID: 241626
License: NP95008776
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ENCINITAS
92024
Binavi, Hownaz NP
477 N El Camino Real Ste D308
Encinitas, CA 92024
(760) 436-2300
Provider ID: 265370
License: NP95010956
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Kurdish,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Elamparo, Kaye NP
477 N El Camino Real Ste D200
Encinitas, CA 92024
(760) 452-3340
Provider ID: 258927
License: NP20795
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Korean,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 51
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
present.
Franz, Cortney NP
477 N El Camino Real Ste D200
Encinitas, CA 92024
(760) 452-3340
Provider ID: 253241
License: NP95004258
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Faiq, Jamila NP
477 N El Camino Real Ste D200
Encinitas, CA 92024
(760) 452-3340
Provider ID: 254824
License: NP95004759
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hooper, Bonnie NP
477 N El Camino Real Ste D308
Encinitas, CA 92024
(760) 436-2300
Provider ID: 275253
License: NP6495
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mwaura, Wairimu NP
477 N El Camino Real Ste D200
Encinitas, CA 92024
(760) 452-3340
Provider ID: 269680
License: NP95009639
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Tablada, Derlyn NP
1130 2nd St
Encinitas, CA 92024
(760) 753-7842
Provider ID: 246117
License: NP95008061
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Tagalog
Cultural Competency: NR
Accessibility: B; Members
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 52
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Tawfilis, Amy NP
320 Santa Fe Dr Ste 108
Encinitas, CA 92024
(760) 436-4558
Provider ID: 276750
License: NP95013902
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Willey, Marti NP
477 N El Camino Real Ste D200
Encinitas, CA 92024
(760) 452-3340
Provider ID: 256422
License: NP22548
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Pidding, Apryl NP
625 Citracado Pkwy Ste 110
Escondido, CA 92025
(760) 747-8935
Provider ID: 269252
License: NP20027
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Spaulding, Enjoli NP
631 E Grand Ave
Escondido, CA 92025
(760) 294-1660
Provider ID: 269259
License: NP21947
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92027
Murray, Carla NP
1509 E Valley Pkwy
Escondido, CA 92027
(760) 520-8100
Provider ID: 242749
License: NP12682
Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 53
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Hours: M-SA 9AM-5PM Bishop, Leslie NP
PTA: No 1955 Citracado Pkwy Ste 102
Cultural Competency: NR Escondido, CA 92029
Accessibility: B; Members (760) 630-3000
should call the provider’s Provider ID: 243219
office to discuss their License: NP95010047
accessibility needs when there Credentials and/or board
is limited access or when certification: No
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM
PTA: No
92029 Cultural Competency: NR
Accessibility: B; Members
Barmack, Kimberly NP should call the provider’s
1955 Citracado Pkwy Ste 200 office to discuss their
Escondido, CA 92029 accessibility needs when there
(760) 743-4789 is limited access or when
Provider ID: 269270 accessibility indicators are not
License: NP20705 present.
Credentials and/or board
certification: No
Accepting New Members: Yes Meyers, Judith NP
Hours: M-SA 9AM-5PM 1955 Citracado Pkwy Ste 300
PTA: No Escondido, CA 92029
Cultural Competency: NR (760) 743-4789
Accessibility: B; Members Provider ID: 274695
should call the provider’s License: NP95010314
office to discuss their Credentials and/or board
accessibility needs when there certification: No
is limited access or when Accepting New Members: Yes
accessibility indicators are not Hours: M-SA 9AM-5PM
present. PTA: No
certification: No
Accepting New Members: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mitruka, Anne NP
1955 Citracado Pkwy Ste 300
Escondido, CA 92029
(760) 743-0546
Provider ID: 269427
License: NP13563
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Elamparo, Kaye NP
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 54
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
9834 Genesee Ave Ste 560
La Jolla, CA 92037
(858) 552-1710
Provider ID: 258928
License: NP20795
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Korean,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Haley, Kathleen NP
9850 Genesee Ave Ste 560
La Jolla, CA 92037
(858) 552-1410
Provider ID: 253506
License: NP11124
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Tawfilis, Amy NP
9850 Genesee Ave Ste 440
La Jolla, CA 92037
(858) 453-5944
Provider ID: 276749
License: NP95013902
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Tomicich, Stephanie NP
9834 Genesee Ave Ste 416
La Jolla, CA 92037
(858) 458-0099
Provider ID: 248026
License: NP95002402
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Loyola, Mary Ann NP
8851 Center Dr Ste 505
La Mesa, CA 91942
(619) 461-3880
Provider ID: 242398
License: NP95011408
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 55
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
office to discuss their (844) 200-2426 office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Aquino, Felino NP
2101 Granger Ave Ste 101a
National City, CA 91950
(844) 200-2426
Provider ID: 244332
License: NP22974
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Aquino, Felino NP
2743 Highland Ave
National City, CA 91950
Provider ID: 244335
License: NP22974
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Aquino, Felino NP
2835 Highland Ave Ste B
National City, CA 91950
(844) 200-2426
Provider ID: 244336
License: NP22974
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Bernardo-gregory, Elsie NP
1428 Highland Ave
National City, CA 91950
(760) 631-5000
Provider ID: 244828
License: NP15257
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Bernardo-gregory, Elsie NP
2835 Highland Ave Ste B
National City, CA 91950
(844) 200-2426
Provider ID: 244833
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 56
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
License: NP15257
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
De Roldan, Sandra NP
610 Euclid Ave Ste 302
National City, CA 91950
(619) 527-7700
Provider ID: 269289
License: NP22506
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Gil, Anna NP
655 Euclid Ave Ste 405
National City, CA 91950
(619) 479-0822
Provider ID: 268795
License: NP95004447
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Khan, Matthew NP
1428 Highland Ave
National City, CA 91950
(619) 474-2284
Provider ID: 238376
License: NP17838
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
OCEANSIDE
92054
Chamberlin, Kaliana NP
517 N Horne St
Oceanside, CA 92054
(760) 631-5000
Provider ID: 273018
License: NP95013030
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 57
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Other Language: Spanish 818 Pier View Way
Clark, Cynthia NP Cultural Competency: NR Oceanside, CA 92054
517 N Horne St Accessibility: B; Members (760) 631-5000
Oceanside, CA 92054 should call the provider’s Provider ID: 245672
(844) 308-5003 office to discuss their License: NP95007944
Provider ID: 240002 accessibility needs when there Credentials and/or board
License: NP16833 is limited access or when certification: No
Credentials and/or board accessibility indicators are not Accepting New Members: Yes
certification: No present. Hours: M-SA 9AM-5PM
Accepting New Members: Yes PTA: No
Hours: M-SA 9AM-5PM Cultural Competency: NR
PTA: No Dapper, Madeline NP Accessibility: B; Members
Other Language: Spanish 818 Pier View Way should call the provider’s
Cultural Competency: NR Oceanside, CA 92054 office to discuss their
Accessibility: B; Members (760) 631-5000 accessibility needs when there
should call the provider’s Provider ID: 278002 is limited access or when
office to discuss their License: NP95016147 accessibility indicators are not
accessibility needs when there Credentials and/or board present.
is limited access or when certification: No
accessibility indicators are not Accepting New Members: Yes 92057 present. Hours: M-SA 9AM-5PM
PTA: No Clark, Cynthia NP
Other Language: Spanish 4700 N River Rd
Clark, Cynthia NP Cultural Competency: NR Oceanside, CA 92057
818 Pier View Way Accessibility: B; Members (844) 308-5003
Oceanside, CA 92054 should call the provider’s Provider ID: 240004
(844) 308-5003 office to discuss their License: NP16833
Provider ID: 240003 accessibility needs when there Credentials and/or board
License: NP16833 is limited access or when certification: No
Credentials and/or board accessibility indicators are not Accepting New Members: Yes
certification: No present. Hours: M-SA 9AM-5PM
Accepting New Members: Yes PTA: No
Hours: M-SA 9AM-5PM Other Language: Spanish
PTA: No Skopek, Rory NP Cultural Competency: NR
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 58
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Accessibility: B; Members (760) 631-5000 office to discuss their
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Eklund, Bonnie NP
4700 N River Rd
Oceanside, CA 92057
(760) 631-5000
Provider ID: 243625
License: NP15285
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Pritzker, Joely NP
4700 N River Rd
Oceanside, CA 92057
Provider ID: 239772
License: NP95000955
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Santiago, Amanda NP
4700 N River Rd
Oceanside, CA 92057
(760) 631-5000
Provider ID: 242607
License: NP95007724
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Bishop, Leslie NP
15611 Pomerado Rd Ste 505
Poway, CA 92064
(760) 631-3000
Provider ID: 243218
License: NP95010047
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Meyers, Judith NP
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3100
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 59
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Provider ID: 257040
License: NP95010314
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Wright, Kimberly NP
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3200
Provider ID: 256378
License: NP95006947
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92102
Watson, Christine NP
995 Gateway Center Way Ste
202
San Diego, CA 92102
(619) 264-3107
Provider ID: 270000
License: NP95006319
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92103
Dwyer, Erin NP
4060 4th Ave Ste 310
San Diego, CA 92103
(619) 297-4707
Provider ID: 269863
License: NP95004184
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hooper, Bonnie NP
4060 4th Ave Ste 415
San Diego, CA 92103
(619) 298-9809
Provider ID: 275255
License: NP6495
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 60
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
accessibility indicators are not
present.
Luckett, De Courcy NP
3520 4th Ave
San Diego, CA 92103
(714) 619-8777
Provider ID: 271115
License: NP95000435
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Pruett, Zhike NP
555 Washington St
San Diego, CA 92103
(949) 209-3473
Provider ID: 269841
License: NP22373
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92114
Buenvenida, Amelia NP
903 Cardiff St
San Diego, CA 92114
(619) 465-3121
Provider ID: 259394
License: NP95004301
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92121
Hooper, Bonnie NP
9339 Genesee Ave Ste 350
San Diego, CA 92121
(858) 454-4300
Provider ID: 275254
License: NP6495
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92123
Albano, Rizalina NP
9610 Granite Ridge Dr Ste B
San Diego, CA 92123
(619) 461-3880
Provider ID: 271000
License: NP95005436
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 61
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
PTA: No 3444 Kearny Villa Rd Ste 202 should call the provider’s
Other Language: Tagalog San Diego, CA 92123 office to discuss their
Cultural Competency: NR (858) 429-7646 accessibility needs when there
Accessibility: B; Members Provider ID: 270968 is limited access or when
should call the provider’s License: PA53170 accessibility indicators are not
office to discuss their Credentials and/or board present.
accessibility needs when there certification: No
is limited access or when Accepting New Members: Yes
accessibility indicators are not Hours: M-SA 9AM-5PM Camargo-lowthers, Angelica
present. PTA: No CNP
Cultural Competency: NR 8010 Frost St Ste 510
Accessibility: B; Members San Diego, CA 92123
Bird, Jeremy NP should call the provider’s (858) 637-4700
3444 Kearny Villa Rd Ste 202 office to discuss their Provider ID: 270981
San Diego, CA 92123 accessibility needs when there License: NP14412
(858) 429-7646 is limited access or when Credentials and/or board
Provider ID: 270968 accessibility indicators are not certification: No
License: NP18833 present. Accepting New Members: Yes
Credentials and/or board Hours: M-SA 9AM-5PM
certification: No PTA: No
Accepting New Members: Yes Camargo-lowthers, Angelica Cultural Competency: NR
Hours: M-SA 9AM-5PM CNP Accessibility: B; Members
PTA: No 8010 Frost St Ste 510 should call the provider’s
Cultural Competency: NR San Diego, CA 92123 office to discuss their
Accessibility: B; Members (858) 637-4700 accessibility needs when there
should call the provider’s Provider ID: 270981 is limited access or when
office to discuss their License: RN521048 accessibility indicators are not
accessibility needs when there Credentials and/or board present.
is limited access or when certification: No
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM Hecker, Carol NP
PTA: No 7901 Frost St
Cultural Competency: NR San Diego, CA 92123
Bird, Jeremy NP Accessibility: B; Members (858) 565-0104
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 62
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Provider ID: 270984
License: NP17354
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92127
Moga, Claire NP
16918 Dove Canyon Rd Ste
103
San Diego, CA 92127
(858) 649-5100
Provider ID: 257026
License: NP95007255
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Willey, Marti NP
16918 Dove Canyon Rd Ste
103
San Diego, CA 92127
(858) 643-5100
Provider ID: 256421
License: NP22548
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92128
Moll, Jocelyn NP
11770 Bernardo Plaza Ct Ste
270
San Diego, CA 92128
(858) 485-0554
Provider ID: 276040
License: NP95010975
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92129
Aquino, Felino NP
9995 Carmel Mountain Rd Ste
B10-b11
San Diego, CA 92129
(844) 200-2426
Provider ID: 244334
License: NP22974
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 63
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Bernardo-gregory, Elsie NP
9995 Carmel Mountain Rd Ste
B10
San Diego, CA 92129
(844) 200-2426
Provider ID: 244829
License: NP15257
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Bernardo-gregory, Elsie NP
9995 Carmel Mountain Rd Ste
B11
San Diego, CA 92129
(844) 200-2426
Provider ID: 244830
License: NP15257
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Orpilla, Imelda NP
9995 Carmel Mountain Rd Ste
B10-b11
San Diego, CA 92129
(844) 200-2426
Provider ID: 243506
License: NP95003211
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92131
Aquino, Felino NP
9855 Erma Rd Ste 105
San Diego, CA 92131
(844) 200-2426
Provider ID: 244333
License: NP22974
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN MARCOS
92069
Coyle, Jennifer NP
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 64
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
838 Nordahl Rd Ste 300 should call the provider’s License: NP95009639
San Marcos, CA 92069 office to discuss their Credentials and/or board
(760) 748-8935 accessibility needs when there certification: No
Provider ID: 253094 is limited access or when Accepting New Members: Yes
License: NP95006591 accessibility indicators are not Hours: M-SA 9AM-5PM
Credentials and/or board present. PTA: No
certification: No Cultural Competency: NR
Accepting New Members: Yes Accessibility: B; Members
Hours: M-SA 9AM-5PM Faiq, Jamila NP should call the provider’s
PTA: No 838 Nordahl Rd Ste 300 office to discuss their
Cultural Competency: NR San Marcos, CA 92069 accessibility needs when there
Accessibility: B; Members (760) 474-8935 is limited access or when
should call the provider’s Provider ID: 254825 accessibility indicators are not
office to discuss their License: NP95004759 present.
accessibility needs when there Credentials and/or board
is limited access or when certification: No
accessibility indicators are not Accepting New Members: Yes Moga, Claire NP
present. Hours: M-SA 9AM-5PM 838 Nordahl Rd Fl 3
PTA: No San Marcos, CA 92069
Cultural Competency: NR (760) 747-8935
Franz, Cortney NP Accessibility: B; Members Provider ID: 257025
838 Nordahl Rd Ste 300 should call the provider’s License: NP95007255
San Marcos, CA 92069 office to discuss their Credentials and/or board
(760) 474-8935 accessibility needs when there certification: No
Provider ID: 257616 is limited access or when Accepting New Members: Yes
License: NP95004258 accessibility indicators are not Hours: M-SA 9AM-5PM
Credentials and/or board present. PTA: No
certification: No Cultural Competency: NR
Accepting New Members: Yes Accessibility: B; Members
Hours: M-SA 9AM-5PM Mwaura, Wairimu NP should call the provider’s
PTA: No 838 Nordahl Rd Ste 300 office to discuss their
Other Language: Spanish San Marcos, CA 92069 accessibility needs when there
Cultural Competency: NR (760) 747-8935 is limited access or when
Accessibility: B; Members Provider ID: 269681 accessibility indicators are not
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 65
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
present. certification: No
VISTA
92083
Clark, Cynthia NP
134 Grapevine Rd
Vista, CA 92083
(760) 631-5000
Provider ID: 240000
License: NP16833
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Clark, Cynthia NP
105 Durian St Ste C
Vista, CA 92083
(760) 631-5000
Provider ID: 240005
License: NP16833
Credentials and/or board
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Cory, Allison NP
134 Grapevine Rd
Vista, CA 92083
(760) 631-5000
Provider ID: 245207
License: NP20497
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dapper, Madeline NP
134 Grapevine Rd
Vista, CA 92083
(760) 631-5000
Provider ID: 278001
License: NP95016147
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Eklund, Bonnie NP
134 Grapevine Rd
Vista, CA 92083
(760) 631-5000
Provider ID: 243624
License: NP15285
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 66
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
PTA: No
Other Language: French
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Kahl, Nicholas NP
134 Grapevine Rd
Vista, CA 92083
(760) 631-5000
Provider ID: 279942
License: NP95006360
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92084
Alvarez, Lisa NP
1000 Vale Terrace Dr
Vista, CA 92084
(760) 631-5000
Provider ID: 278537
License: NP19911
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Chamberlin, Kaliana NP
1000 Vale Terrace Dr
Vista, CA 92084
(760) 631-5000
Provider ID: 271067
License: NP95013030
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Clark, Cynthia NP
1000 Vale Terrace Dr
Vista, CA 92084
(844) 308-5003
Provider ID: 240001
License: NP16833
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dapper, Madeline NP
1000 Vale Terrace Dr
Vista, CA 92084
(760) 631-5000
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 67
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Provider ID: 278000 office to discuss their License: NP95006826
License: NP95016147 accessibility needs when there Credentials and/or board
Credentials and/or board is limited access or when certification: No
certification: No accessibility indicators are not Accepting New Members: Yes
Accepting New Members: Yes present. Hours: M-SA 9AM-5PM
Hours: M-SA 9AM-5PM PTA: No
PTA: No Other Language: Chinese
Other Language: Spanish Eklund, Bonnie NP Cultural Competency: NR
Cultural Competency: NR 1000 Vale Terrace Dr Accessibility: B; Members
Accessibility: B; Members Vista, CA 92084 should call the provider’s
should call the provider’s (760) 631-5000 office to discuss their
office to discuss their Provider ID: 243623 accessibility needs when there
accessibility needs when there License: NP15285 is limited access or when
is limited access or when Credentials and/or board accessibility indicators are not
accessibility indicators are not certification: No present.
present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No Kousari, Jhaleh NP
Dekkers-o'hare, Ingrid NP Other Language: French 1000 Vale Terrace Dr
1000 Vale Terrace Dr Cultural Competency: NR Vista, CA 92084
Vista, CA 92084 Accessibility: B; Members (760) 631-5000
(760) 631-5000 should call the provider’s Provider ID: 239793
Provider ID: 241299 office to discuss their License: NP20893
License: NP8665 accessibility needs when there Credentials and/or board
Credentials and/or board is limited access or when certification: No
certification: No accessibility indicators are not Accepting New Members: Yes
Accepting New Members: Yes present. Hours: M-SA 9AM-5PM
Hours: M-SA 9AM-5PM PTA: No
PTA: No Other Language: Farsi,
Other Language: Spanish, Halgedahl, Yi NP Spanish
Vietnamese 1000 Vale Terrace Dr Cultural Competency: NR
Cultural Competency: NR Vista, CA 92084 Accessibility: B; Members
Accessibility: B; Members (760) 631-5000 should call the provider’s
should call the provider’s Provider ID: 241907 office to discuss their
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 68
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Nicholas, Estela NP
1000 Vale Terrace Dr
Vista, CA 92084
(760) 631-5000
Provider ID: 239866
License: NP11448
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Pateman, Carolyn NP
1000 Vale Terrace Dr
Vista, CA 92084
(760) 631-5000
Provider ID: 239976
License: NP10896
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Pritzker, Joely NP
1000 Vale Terrace Dr
Vista, CA 92084
(760) 631-5000
Provider ID: 239773
License: NP95000955
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Smith, Sharon NP
1000 Vale Terrace Dr
Vista, CA 92084
(760) 631-5000
Provider ID: 242508
License: NP15444
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Smith, Sharon NP
1000 Vale Terrace Dr
Vista, CA 92084
(760) 631-5000
Provider ID: 242508
License: RN428876
Credentials and/or board
certification: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 69
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Certified Registered Nurse
Anesthetist
ESCONDIDO
92025
Seilnacht Bernard, Karen
CRNA
488 E Valley Pkwy
Escondido, CA 92025
(760) 203-5321
Provider ID: 269203
License: RN409982
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Seilnacht Bernard, Karen
CRNA
488 E Valley Pkwy
Escondido, CA 92025
(760) 203-5321
Provider ID: 269203
License: NA1876
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Serrano, Melinda CRNA
9300 Campus Point Dr
La Jolla, CA 92037
(619) 543-5754
Provider ID: 269366
License: NA95000147
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dermatology
CARLSBAD
92011
Brouha, Brook MD
6010 Hidden Valley Rd Ste 120
Carlsbad, CA 92011
(760) 884-5990
Provider ID: 267945
License: A97902
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 70
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Special Expertise: HIV/AIDS
CHULA VISTA
91910
Stein, Alexander MD
340 Fourth Ave Ste 14
Chula Vista, CA 91910
(619) 303-3681
Provider ID: 268620
License: A106295
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
Romanian
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
EL CAJON
92020
Brogan, Jacqueline MD
292 Avocado Ave
El Cajon, CA 92020
(619) 579-5115
Provider ID: 265251
License: A160890
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Cohen, Philip MD
292 Avocado Ave
El Cajon, CA 92020
(619) 579-5115
Provider ID: 202211
License: G89274
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Crowley, Christopher MD
292 Avocado Ave
El Cajon, CA 92020
(619) 579-5115
Provider ID: 269669
License: A134188
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 71
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Other Language: Chinese,
Celano, Nicholas MD Mandarin, Spanish Resh, William MD
292 Avocado Ave Cultural Competency: NR 292 Avocado Ave
El Cajon, CA 92020 Accessibility: B; Members El Cajon, CA 92020
(619) 579-5115 should call the provider’s (619) 579-5115
Provider ID: 269114 office to discuss their Provider ID: 269099
License: A120411 accessibility needs when there License: C34661
Credentials and/or board is limited access or when Credentials and/or board
certification: No accessibility indicators are not certification: No
Accepting New Members: Yes present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM Hours: M-SA 9AM-5PM
PTA: No PTA: No
Other Language: Spanish Kassab, Ghada MD Cultural Competency: NR
Cultural Competency: NR 330 S Magnolia Ave Accessibility: B; Members
Accessibility: B; Members El Cajon, CA 92020 should call the provider’s
should call the provider’s (858) 273-2726 office to discuss their
office to discuss their Provider ID: 129190 accessibility needs when there
accessibility needs when there License: A114457 is limited access or when
is limited access or when Credentials and/or board accessibility indicators are not
accessibility indicators are not certification: No present.
present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No Sateesh, Brooke MD
Chiang, Jennifer MD Other Language: Arabic, 292 Avocado Ave
292 Avocado Ave Spanish El Cajon, CA 92020
El Cajon, CA 92020 Cultural Competency: NR (619) 579-5115
(619) 579-5115 Accessibility: B; Members Provider ID: 269154
Provider ID: 269156 should call the provider’s License: A109670
License: A120528 office to discuss their Credentials and/or board
Credentials and/or board accessibility needs when there certification: No
certification: No is limited access or when Accepting New Members: Yes
Accepting New Members: Yes accessibility indicators are not Hours: M-SA 9AM-5PM
Hours: M-SA 9AM-5PM present. PTA: No
PTA: No Cultural Competency: NR
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 72
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ENCINITAS
92024
Gladsjo, Julie MD
477 N El Camino Real Ste D308
Encinitas, CA 92024
(760) 436-2300
Provider ID: 269052
License: A98641
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hemperly, Stephen DO
477 N El Camino Real Ste D308
Encinitas, CA 92024
(760) 436-2300
Provider ID: 243725
License: 20A14658
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Riley, Jessica DO
477 N El Camino Real Ste D308
Encinitas, CA 92024
(760) 436-2300
Provider ID: 243457
License: 20A16345
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Tompkins, Stacy MD
477 N El Camino Real Ste D308
Encinitas, CA 92024
(760) 436-2300
Provider ID: 246363
License: A52958
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
FALLBROOK
92028
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 73
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Ross, Andrew MD
1309 S Mission Rd Ste A
Fallbrook, CA 92028
(760) 728-7546
Provider ID: 269334
License: A140430
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Samady, Joseph MD
1309 S Mission Rd Ste A
Fallbrook, CA 92028
(760) 728-7546
Provider ID: 269328
License: A71411
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Crowley, Christopher MD
9300 Campus Point Dr
La Jolla, CA 92037
(858) 657-8322
Provider ID: 269668
License: A134188
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Miremadi, Arjamg MD
7702 Ivanhoe Ave
La Jolla, CA 92037
(858) 456-1840
Provider ID: 122520
License: A31016
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Brogan, Jacqueline MD
655 Euclid Ave Ste 401
National City, CA 91950
(619) 267-8303
Provider ID: 265250
License: A160890
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 74
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Other Language: Spanish 655 Euclid Ave Ste 401 should call the provider’s
Cultural Competency: NR National City, CA 91950 office to discuss their
Accessibility: B; Members (619) 267-8303 accessibility needs when there
should call the provider’s Provider ID: 269667 is limited access or when
office to discuss their License: A134188 accessibility indicators are not
accessibility needs when there Credentials and/or board present.
is limited access or when certification: No
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM Chiang, Jennifer MD
PTA: No 655 Euclid Ave Ste 401
Cultural Competency: NR National City, CA 91950
Cohen, Philip MD Accessibility: B; Members (619) 267-8303
655 Euclid Ave Ste 401 should call the provider’s Provider ID: 269157
National City, CA 91950 office to discuss their License: A120528
(619) 267-8303 accessibility needs when there Credentials and/or board
Provider ID: 202210 is limited access or when certification: No
License: G89274 accessibility indicators are not Accepting New Members: Yes
Credentials and/or board present. Hours: M-SA 9AM-5PM
certification: No PTA: No
Accepting New Members: Yes Other Language: Chinese,
Hours: M-SA 9AM-5PM Celano, Nicholas MD Mandarin, Spanish
PTA: No 655 Euclid Ave Ste 401 Cultural Competency: NR
Other Language: Spanish National City, CA 91950 Accessibility: B; Members
Cultural Competency: NR (619) 267-8303 should call the provider’s
Accessibility: B; Members Provider ID: 269115 office to discuss their
should call the provider’s License: A120411 accessibility needs when there
office to discuss their Credentials and/or board is limited access or when
accessibility needs when there certification: Yes accessibility indicators are not
is limited access or when Accepting New Members: Yes present.
accessibility indicators are not Hours: M-SA 9AM-5PM
present. PTA: No
Other Language: Spanish Nelson, Aislyn MD
Cultural Competency: NR 655 Euclid Ave Ste 401
Crowley, Christopher MD Accessibility: B; Members National City, CA 91950
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 75
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
(619) 267-8303 accessibility needs when there certification: No
Provider ID: 246490
License: A147913
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Resh, William MD
655 Euclid Ave Ste 401
National City, CA 91950
(619) 267-8303
Provider ID: 269100
License: C34661
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
is limited access or when
accessibility indicators are not
present.
Sateesh, Brooke MD
655 Euclid Ave Ste 401
National City, CA 91950
(619) 267-8303
Provider ID: 269155
License: A109670
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Uebelhoer, Nathan DO
655 Euclid Ave Ste 401
National City, CA 91950
(619) 267-8303
Provider ID: 269137
License: 20A9328
Credentials and/or board
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
OCEANSIDE
92056
Angra, Kunal MD
3629 Vista Way
Oceanside, CA 92056
(760) 757-7546
Provider ID: 276058
License: A161745
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 76
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
present. Hours: M-SA 9AM-5PM present.
PTA: Yes
Other Language: Danish,
Aguirre, Kristen MD German, Hebrew, Ross, Andrew MD
3629 Vista Way Norwegian, Polish, Spanish, 3629 Vista Way
Oceanside, CA 92056 Swedish Oceanside, CA 92056
(760) 757-7546 Cultural Competency: NR (760) 757-7546
Provider ID: 243076 Accessibility: B; Members Provider ID: 269333
License: A135075 should call the provider’s License: A140430
Credentials and/or board office to discuss their Credentials and/or board
certification: No accessibility needs when there certification: No
Accepting New Members: Yes is limited access or when Accepting New Members: Yes
Hours: M-SA 9AM-5PM accessibility indicators are not Hours: M-SA 9AM-5PM
PTA: No present. PTA: No
Other Language: Spanish Other Language: Spanish
Cultural Competency: NR Cultural Competency: NR
Accessibility: B; Members Kim, Jessica DO Accessibility: B; Members
should call the provider’s 3629 Vista Way should call the provider’s
office to discuss their Oceanside, CA 92056 office to discuss their
accessibility needs when there (760) 757-7546 accessibility needs when there
is limited access or when Provider ID: 247630 is limited access or when
accessibility indicators are not License: 20A17031 accessibility indicators are not
present. Credentials and/or board present.
certification: No
Accepting New Members: Yes
Gilboa, Ruth MD Hours: M-SA 9AM-5PM Samady, Joseph MD
3629 Vista Way PTA: No 3629 Vista Way
Oceanside, CA 92056 Cultural Competency: NR Oceanside, CA 92056
(760) 757-7546 Accessibility: B; Members (760) 757-7546
Provider ID: 269414 should call the provider’s Provider ID: 269327
License: A46557 office to discuss their License: A71411
Credentials and/or board accessibility needs when there Credentials and/or board
certification: No is limited access or when certification: Yes
Accepting New Members: Yes accessibility indicators are not Accepting New Members: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 77
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Hours: M-SA 9AM-5PM 3629 Vista Way office to discuss their
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Thiele, Jens MD
3629 Vista Way
Oceanside, CA 92056
(760) 757-7546
Provider ID: 269412
License: A103862
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Venkat, Arun MD
Oceanside, CA 92056
(760) 757-7546
Provider ID: 269345
License: A125103
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Wong, Darryl MD
3629 Vista Way
Oceanside, CA 92056
(760) 757-7546
Provider ID: 269368
License: G70557
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Armstrong, Patrick MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3145
Provider ID: 269732
License: A137103
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Jou, Paul MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3145
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 78
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Provider ID: 269479
License: A148966
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Shewmake, Stephen MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3140
Provider ID: 88451
License: G36481
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92103
Boen, Monica MD
4060 4th Ave Ste 415
San Diego, CA 92103
(619) 298-9809
Provider ID: 269741
License: A149554
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
Polish, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hamman, Michael MD
4060 4th Ave Ste 415
San Diego, CA 92103
(619) 298-9809
Provider ID: 241043
License: A97551
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hemperly, Stephen DO
4060 4th Ave Ste 415
San Diego, CA 92103
(619) 298-9809
Provider ID: 243726
License: 20A14658
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 79
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
accessibility indicators are not
present.
Levin, Jacqueline DO
4060 4th Ave Ste 415
San Diego, CA 92103
(619) 298-9809
Provider ID: 242685
License: 20A12190
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Special Expertise: HIV/AIDS
Reed, Kelly DO
4060 4th Ave Ste 415
San Diego, CA 92103
(619) 298-9809
Provider ID: 242598
License: 20A15550
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Shiell, Ronald MD
4060 4th Ave Ste 415
San Diego, CA 92103
(619) 289-9809
Provider ID: 242596
License: G70359
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Simzar, Soheil MD
4060 4th Ave Ste 415
San Diego, CA 92103
(619) 298-9809
Provider ID: 242621
License: A97769
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Zaleski Larsen, Lisa DO
4060 4th Ave Ste 415
San Diego, CA 92103
(619) 298-9809
Provider ID: 242549
License: 20A13774
Credentials and/or board
certification: No
Accepting New Members: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 80
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92117
Kassab, Ghada MD
3737 Moraga Ave Ste A206
San Diego, CA 92117
(858) 273-2726
Provider ID: 245638
License: A114457
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92119
Stein, Alexander MD
6280 Jackson Dr Ste 8
San Diego, CA 92119
(619) 303-3062
Provider ID: 268621
License: A106295
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
Romanian
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92120
Shahan, Fred MD
6367 Alvarado Ct Ste 107
San Diego, CA 92120
(619) 287-1882
Provider ID: 65605
License: G83901
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92121
Boen, Monica MD
9339 Genesee Ave Ste 350
San Diego, CA 92121
(858) 454-4300
Provider ID: 269740
License: A149554
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
Polish, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 81
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
is limited access or when
accessibility indicators are not
present.
Reed, Kelly DO
9339 Genesee Ave Ste 350
San Diego, CA 92121
(858) 454-4300
Provider ID: 242599
License: 20A15550
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Tompkins, Stacy MD
9333 Genesee Ave Ste 350a
San Diego, CA 92121
(858) 454-4300
Provider ID: 246364
License: A52958
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92123
Nahm, Walter MD
7695 Cardinal Ct Ste 200
San Diego, CA 92123
(858) 278-8835
Provider ID: 69317
License: A78569
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Korean,
Spanish, Tagalog
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92130
Gray, Jayla MD
4765 Carmel Mountain Rd Ste
201
San Diego, CA 92130
(858) 369-7546
Provider ID: 279378
License: A169832
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN MARCOS
92069
Kim, Jessica DO
838 Nordahl Rd Ste 250
San Marcos, CA 92069
(760) 738-7600
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 82
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Provider ID: 247631
License: 20A17031
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Venkat, Arun MD
838 Nordahl Rd Ste 250
San Marcos, CA 92069
(760) 738-7600
Provider ID: 269347
License: A125103
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SOLANA BEACH
92075
Gilboa, Ruth MD
530 Lomas Santa Fe Dr Ste D
Solana Beach, CA 92075
(858) 259-0056
Provider ID: 269415
License: A46557
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Danish,
German, Hebrew,
Norwegian, Polish, Spanish,
Swedish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Ross, Andrew MD
530 Lomas Santa Fe Dr Ste D
Solana Beach, CA 92075
(858) 259-0056
Provider ID: 269335
License: A140430
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Venkat, Arun MD
530 Lomas Santa Fe Dr Ste D
Solana Beach, CA 92075
(858) 259-2256
Provider ID: 269346
License: A125103
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 83
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Emergency Medicine
POWAY
92064
Fiore, Joseph MD
15611 Pomerado Rd Fl 3 North
Poway, CA 92064
(858) 675-3200
Provider ID: 269787
License: A42159
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Endocrinology
CHULA VISTA
91910
Rogers, Megan MD
480 4th Ave Ste 202
Chula Vista, CA 91910
(619) 427-3362
Provider ID: 268585
License: A122784
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Family Practice Sports
Medicine
SAN DIEGO
92127
Spring, Jason DO
16918 Dove Canyon Rd
San Diego, CA 92127
(858) 924-1900
Provider ID: 271551
License: 20A9497
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Family Practice
CARLSBAD
92011
Madhav, Kinjal MD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 244004
License: A132338
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Gujarati,
Hindi, Spanish
Cultural Competency: NR
Accessibility: B; Members
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 84
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Female Pelvic Med and
Reconstructive Surg
Moukarzel, Elias MD
6125 Paseo Del Norte Ste 140
Carlsbad, CA 92011
(760) 352-4103
Provider ID: 269151
License: C50303
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
French, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Gastroenterology
CHULA VISTA
91910
Duque, John MD
480 4th Ave Ste 316
Chula Vista, CA 91910
(619) 691-0240
Provider ID: 268572
License: G48442
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hassanein, Tarek MD
256 Landis Ave Ste 202
Chula Vista, CA 91910
(619) 332-1221
Provider ID: 269555
License: A54452
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
French, German, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
91911
Hassanein, Tarek MD
1323 3rd Ave
Chula Vista, CA 91911
(619) 409-6900
Provider ID: 269558
License: A54452
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
French, German, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 85
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
accessibility indicators are not
present.
CORONADO
92118
Gutierrez, Julio MD
131 Orange Ave Ste 101
Coronado, CA 92118
(619) 522-0399
Provider ID: 270435
License: A107985
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Lajin, Michael MD
230 Prospect Pl Ste 220
Coronado, CA 92118
(619) 460-4055
Provider ID: 269837
License: C53475
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
German, Japanese, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
EL CAJON
92020
Hassanein, Tarek MD
463 N Magnolia Ave
El Cajon, CA 92020
(619) 522-0399
Provider ID: 269556
License: A54452
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
French, German, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Imperial, Joanne MD
465 N Magnolia Ave
El Cajon, CA 92020
(619) 359-8380
Provider ID: 268979
License: G44420
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ENCINITAS
92024
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 86
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Singh, Marvin MD
700 Garden View Ct Ste 102
Encinitas, CA 92024
(760) 783-0441
Provider ID: 123127
License: A102749
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Korean,
Russian, Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
OCEANSIDE
92056
Chiao, Hellen MD
3923 Waring Rd Ste A
Oceanside, CA 92056
(760) 724-8782
Provider ID: 128127
License: A127722
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Cantonese,
Mandarin, Spanish,
Taiwanese, Yue Chinese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Devereaux, Christopher MD
3923 Waring Rd Ste A
Oceanside, CA 92056
(760) 724-8782
Provider ID: 41551
License: G75223
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Krol, Thomas MD
3923 Waring Rd Ste A
Oceanside, CA 92056
(760) 724-8782
Provider ID: 41549
License: G43649
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Shad, Javaid MD
3923 Waring Rd Ste A
Oceanside, CA 92056
(760) 724-8782
Provider ID: 41554
License: G86962
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 87
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Other Language: Hindi, Urdu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Shim, Michael MD
3923 Waring Rd Ste A
Oceanside, CA 92056
(760) 724-8782
Provider ID: 41553
License: A88942
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Viernes, Matthew MD
3923 Waring Rd Ste A
Oceanside, CA 92056
(760) 724-8782
Provider ID: 41552
License: A61516
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Zakko, Maram MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3150
Provider ID: 270028
License: A64346
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Armenian,
Chinese, Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92102
Hassanein, Tarek MD
995 Gateway Center Way Ste
105
San Diego, CA 92102
(619) 264-1934
Provider ID: 269557
License: A54452
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
French, German, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 88
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
accessibility indicators are not
present.
92120
Reddy, Ananthram MD
6699 Alvarado Rd Ste 2301
San Diego, CA 92120
(619) 229-1005
Provider ID: 34354
License: C52423
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Cambodian,
Hindi, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SANTEE
92071
Reddy, Ananthram MD
9456 Cuyamaca St Ste 102
Santee, CA 92071
(619) 588-4074
Provider ID: 69412
License: C52423
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Cambodian,
Hindi, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Geriatric Medicine
CHULA VISTA
91910
Gutierrez, Aireen MD
480 Fourth Ave Ste 202
Chula Vista, CA 91910
(619) 427-3361
Provider ID: 268646
License: A77031
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Schwartz, Martin MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3135
Provider ID: 122531
License: G39185
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 89
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
SAN DIEGO
92129
Miller, Scott MD
9878 Carmel Mountain Rd Ste
B
San Diego, CA 92129
(858) 312-1440
Provider ID: 271539
License: G129295
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hearing Aid Dealer / Supplier
CARLSBAD
92008
Davis, Kelle MA
1820 Marron Rd Ste 102
Carlsbad, CA 92008
(760) 434-0125
Provider ID: 268654
License: HA6083
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CHULA VISTA
91910
Anderson, Elaine MA
310 Third Ave Ste C11
Chula Vista, CA 91910
(619) 426-0841
Provider ID: 268688
License: HA7100
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Davis, Kelle MA
310 Third Ave Ste C11
Chula Vista, CA 91910
(619) 426-0841
Provider ID: 268651
License: HA6083
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CORONADO
92118
Davis, Kelle MA
801 Orange Ave
Coronado, CA 92118
(619) 437-8154
Provider ID: 268655
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 90
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
License: HA6083
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
EL CAJON
92021
Anderson, Elaine MA
1767 E Main St
El Cajon, CA 92021
(619) 440-6516
Provider ID: 268692
License: HA7100
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dandurand, John MA
1767 E Main St
El Cajon, CA 92021
(619) 440-6516
Provider ID: 269780
License: HA2056
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Davis, Kelle MA
1767 E Main St
El Cajon, CA 92021
(619) 440-6516
Provider ID: 268650
License: HA6083
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Anderson, Elaine MA
330 W Felicita Ave Ste A4
Escondido, CA 92025
(760) 489-1323
Provider ID: 268690
License: HA7100
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 91
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Dandurand, John MA
330 W Felicita Ave Ste A4
Escondido, CA 92025
(760) 489-1323
Provider ID: 269783
License: HA2056
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Anderson, Elaine MA
5565 Grossmont Center Dr
La Mesa, CA 91942
(619) 589-5414
Provider ID: 268693
License: HA7100
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dandurand, John MA
5565 Grossmont Center Dr
La Mesa, CA 91942
(619) 589-5414
Provider ID: 269782
License: HA2056
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92120
Anderson, Elaine MA
6367 Alvarado Ct Ste 101
San Diego, CA 92120
(619) 583-7002
Provider ID: 268689
License: HA7100
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dandurand, John MA
6367 Alvarado Ct
San Diego, CA 92120
(858) 259-4182
Provider ID: 269781
License: HA2056
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 92
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Davis, Kelle MA
6367 Alvarado Ct Ste 101
San Diego, CA 92120
(619) 583-7002
Provider ID: 268652
License: HA6083
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92123
Anderson, Elaine MA
9340 Clairemont Mesa Blvd Ste
D
San Diego, CA 92123
(858) 278-9911
Provider ID: 268691
License: HA7100
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Davis, Kelle MA
9340 Clairemont Mesa Blvd Ste
D
San Diego, CA 92123
(858) 278-9911
Provider ID: 268653
License: HA6083
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SOLANA BEACH
92075
Dandurand, John MA
740 Lomas Santa Fe Dr Ste 110
Solana Beach, CA 92075
(858) 259-4182
Provider ID: 269779
License: HA2056
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hematology / Oncology
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 93
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
ENCINITAS
92024
Bessudo, Alberto MD
326 Santa Fe Dr Ste 105
Encinitas, CA 92024
(760) 452-3340
Provider ID: 278508
License: A50309
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Hebrew,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Flores, Edna MD
477 N El Camino Real Ste D200
Encinitas, CA 92024
(760) 452-3440
Provider ID: 256367
License: A114373
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sullivan, Jessica DO
477 N El Camino Real Ste D200
Encinitas, CA 92024
(760) 452-3340
Provider ID: 243484
License: 20A16273
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Banerjee, Pushpendu MD
9850 Genesee Ave Ste 560
La Jolla, CA 92037
(858) 552-1410
Provider ID: 257619
License: A69490
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Hindi
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Flores, Edna MD
9850 Genesee Ave Ste 830
La Jolla, CA 92037
(858) 552-1410
Provider ID: 256366
License: A114373
Credentials and/or board
certification: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 94
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Batra, Reema MD
5555 Grossmont Center Dr
La Mesa, CA 91942
(619) 644-3030
Provider ID: 58612
License: A118846
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Hindi,
Mandarin
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Bodkin, David MD
5555 Grossmont Center Dr
La Mesa, CA 91942
(619) 644-3030
Provider ID: 44084
License: G62107
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic,
French, Hindi, Korean,
Mandarin, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Medic, Igor MD
5555 Grossmont Center Dr
La Mesa, CA 91942
(619) 644-3030
Provider ID: 119509
License: A146970
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Serbian, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Zu, Kai MD
5555 Grossmont Center Dr
La Mesa, CA 91942
(619) 644-3030
Provider ID: 43199
License: A74842
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Mandarin,
Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 95
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92127
Bessudo, Alberto MD
16918 Dove Canyon Rd Ste
103
San Diego, CA 92127
(858) 649-5100
Provider ID: 256962
License: A50309
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Hebrew,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Eisenberg, Steven DO
16918 Dove Canyon Rd Ste
103
San Diego, CA 92127
(858) 649-5100
Provider ID: 242455
License: 20A8293
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Lamon, Joel MD
16918 Dove Canyon Rd Ste
103
San Diego, CA 92127
(858) 649-5100
Provider ID: 241036
License: G28164
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
German, Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN MARCOS
92069
Bessudo, Alberto MD
838 Nordahl Rd Ste 300
San Marcos, CA 92069
(760) 452-3340
Provider ID: 256963
License: A50309
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Hebrew,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 96
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
accessibility indicators are not
present.
Eisenberg, Steven DO
838 Nordahl Rd Ste 300
San Marcos, CA 92069
(760) 747-8935
Provider ID: 242456
License: 20A8293
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Kosmo, Michael MD
838 Nordahl Rd Ste 300
San Marcos, CA 92069
(760) 747-8935
Provider ID: 241034
License: G54074
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
German, Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Lamon, Joel MD
838 Nordahl Rd Ste 300
San Marcos, CA 92069
(760) 747-8935
Provider ID: 241037
License: G28164
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
German, Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sullivan, Jessica DO
838 Nordahl Rd Ste 300
San Marcos, CA 92069
(760) 747-8935
Provider ID: 269662
License: 20A16273
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hospice and Palliative
Medicine
Pasha, Sabiha MD
838 Nordahl Rd Ste 300
San Marcos, CA 92069
(760) 747-8935
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 97
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Provider ID: 276669
License: C50413
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: German,
Spanish, Urdu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Infectious Disease
NATIONAL CITY
91950
Cabinian, Antonio MD
655 Euclid Ave Ste 209
National City, CA 91950
(619) 470-7000
Provider ID: 127991
License: A45959
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92103
Katsivas, Theodoros MD
4168 Front St
San Diego, CA 92103
(619) 543-3000
Provider ID: 269840
License: A78543
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: German,
Greek, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Internal Medicine Critical
Care Medicine
ESCONDIDO
92025
Hirsch, Gregory MD
488 E Valley Pkwy Ste 211
Escondido, CA 92025
(760) 489-1458
Provider ID: 269143
License: G40467
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Otoshi, James MD
488 E Valley Pkwy Ste 201
Escondido, CA 92025
(760) 489-1458
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 98
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Provider ID: 269095
License: G27763
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Hirsch, Gregory MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3100
Provider ID: 53775
License: G40467
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Internal Medicine
CHULA VISTA
91910
Argoud, Georges MD
340 Fourth Ave Ste 7a
Chula Vista, CA 91910
(619) 691-0388
Provider ID: 217421
License: G61898
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
91911
Narayanan, Meena MD
765 Medical Center Ct Ste 211
Chula Vista, CA 91911
(619) 616-2100
Provider ID: 247694
License: A113448
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ENCINITAS
92024
Dilauro, Steven MD
700 Garden View Ct Ste 102
Encinitas, CA 92024
(760) 783-0441
Provider ID: 66036
License: A104332
Credentials and/or board
certification: Yes
Accepting New Members: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 99
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Goldklang, Robert MD
700 Garden View Ct Ste 102
Encinitas, CA 92024
(760) 783-0441
Provider ID: 66037
License: G69237
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Lajoie, Adrianne MD
700 Garden View Ct Ste 102
Encinitas, CA 92024
(760) 783-0441
Provider ID: 65629
License: A84301
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Chelimilla, Haritha MD
735 E Ohio Ave Ste 204
Escondido, CA 92025
(760) 294-7600
Provider ID: 269204
License: A124727
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Hindi,
Telugu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Gara, Naveen MD
661 E Pennsylvania Ave
Escondido, CA 92025
(760) 690-2800
Provider ID: 269145
License: A149265
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Hindi,
Telugu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 100
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
present. Hours: M-SA 9AM-5PM Malek, Mikhail MD
92029
Acheatel, Roger MD
1955 Citracado Pkwy Ste 300
Escondido, CA 92029
(760) 743-0546
Provider ID: 269351
License: G45947
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Chen, Andrew MD
1955 Citracado Pkwy Ste 300
Escondido, CA 92029
(760) 743-0546
Provider ID: 269314
License: A120866
Credentials and/or board
certification: No
Accepting New Members: Yes
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Lee, Young MD
1955 Citracado Pkwy Ste 300
Escondido, CA 92029
(760) 743-0546
Provider ID: 269316
License: A130275
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Korean
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
1955 Citracado Pkwy Ste 300
Escondido, CA 92029
(760) 743-0546
Provider ID: 269307
License: A50952
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Dilauro, Steven MD
9850 Genesee Ave Ste 440
La Jolla, CA 92037
(858) 373-0211
Provider ID: 269298
License: A104332
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 101
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Goldklang, Robert MD
9850 Genesee Ave Ste 440
La Jolla, CA 92037
(858) 373-0211
Provider ID: 269271
License: G69237
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Lajoie, Adrianne MD
9850 Genesee Ave Ste 440
La Jolla, CA 92037
(858) 373-0211
Provider ID: 269300
License: A84301
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Wallach, Sabina MD
9850 Genesee Ave Ste 400
La Jolla, CA 92037
(858) 558-8666
Provider ID: 269286
License: A34070
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: French,
Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Acheatel, Roger MD
15611 Pomerado Rd Ste 580
Poway, CA 92064
(858) 592-2696
Provider ID: 272330
License: G45947
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 102
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Chen, Andrew MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 592-2696
Provider ID: 269315
License: A120866
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92114
Narayanan, Meena MD
292 Euclid Ave Ste 210
San Diego, CA 92114
(619) 616-2100
Provider ID: 247695
License: A113448
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN MARCOS
92078
Narayanan, Meena MD
955 Boardwalk Ste 100
San Marcos, CA 92078
(760) 798-8855
Provider ID: 247696
License: A113448
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SOLANA BEACH
92075
Argoud, Georges MD
530 Lomas Santa Fe Dr Ste 8
Solana Beach, CA 92075
(858) 704-4151
Provider ID: 268581
License: G61898
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Interventional Cardiology
CHULA VISTA
91911
Carlson, Steven MD
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 103
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
751 Medical Center Ct Ste 211
Chula Vista, CA 91911
(619) 616-2100
Provider ID: 244812
License: A109957
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Taghizadeh, Behzad MD
8851 Center Dr Ste 405
La Mesa, CA 91942
(619) 582-2404
Provider ID: 269161
License: C56208
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92114
Carlson, Steven MD
292 Euclid Ave Ste 210
San Diego, CA 92114
(619) 616-2100
Provider ID: 244810
License: A109957
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN MARCOS
92078
Carlson, Steven MD
955 Boardwalk Ste 100
San Marcos, CA 92078
(760) 798-8855
Provider ID: 244811
License: A109957
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Neonatal / Perinatal Medicine
SAN DIEGO
92101
Farrell, Maureen MD
2017 1st Ave Ste 201
San Diego, CA 92101
(619) 881-4589
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 104
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Provider ID: 270157 is limited access or when Accepting New Members: Yes
License: A82843 accessibility indicators are not Hours: M-SA 9AM-5PM
Credentials and/or board present. PTA: No
certification: No Other Language: Spanish
Accepting New Members: Yes Cultural Competency: NR
Hours: M-SA 9AM-5PM Mody, Sheila MD Accessibility: B; Members
PTA: No 2017 1st Ave Ste 100 should call the provider’s
Cultural Competency: NR San Diego, CA 92101 office to discuss their
Accessibility: B; Members (619) 543-6777 accessibility needs when there
should call the provider’s Provider ID: 270296 is limited access or when
office to discuss their License: A117818 accessibility indicators are not
accessibility needs when there Credentials and/or board present.
is limited access or when certification: No
accessibility indicators are not Accepting New Members: Yes 92114 present. Hours: M-SA 9AM-5PM
PTA: No Culwell, Kelly MD
Cultural Competency: NR 220 Euclid Ave Ste 30
Marengo Barbick, Antoinette Accessibility: B; Members San Diego, CA 92114
MD should call the provider’s (916) 734-6925
2017 1st Ave Ste 301 office to discuss their Provider ID: 270475
San Diego, CA 92101 accessibility needs when there License: A76983
(619) 881-4500 is limited access or when Credentials and/or board
Provider ID: 271176 accessibility indicators are not certification: No
License: A87783 present. Accepting New Members: Yes
Credentials and/or board Hours: M-SA 9AM-5PM
certification: No PTA: No
Accepting New Members: Yes Robertson, Lauren MD Cultural Competency: NR
Hours: M-SA 9AM-5PM 2017 1st Ave Ste 100 Accessibility: B; Members
PTA: No San Diego, CA 92101 should call the provider’s
Cultural Competency: NR (858) 455-7520 office to discuss their
Accessibility: B; Members Provider ID: 271054 accessibility needs when there
should call the provider’s License: A109671 is limited access or when
office to discuss their Credentials and/or board accessibility indicators are not
accessibility needs when there certification: No present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 105
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Cassey, Lindsay DO
220 Euclid Ave Ste 30
San Diego, CA 92114
(209) 576-3526
Provider ID: 270421
License: 20A14218
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
VISTA
92084
Movahhedian, Hamid MD
1000 Vale Terrace Dr
Vista, CA 92084
(760) 631-5000
Provider ID: 246863
License: A49253
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Faroese,
Farsi
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Nephrology
CHULA VISTA
91910
Bedoya, Luis MD
340 4th Ave Ste 4
Chula Vista, CA 91910
(619) 427-1144
Provider ID: 39369
License: A51105
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Espinosa-melendez, Enrique
MD
480 4th Ave Ste 507
Chula Vista, CA 91910
(619) 477-7779
Provider ID: 121742
License: C42745
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
Portuguese, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Horeish, Adam MD
340 4th Ave Ste 4
Chula Vista, CA 91910
(619) 427-1144
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 106
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Provider ID: 99947 should call the provider’s Provider ID: 31395
License: C56089 office to discuss their License: A90108
Credentials and/or board accessibility needs when there Credentials and/or board
certification: No is limited access or when certification: No
Accepting New Members: Yes accessibility indicators are not Accepting New Members: Yes
Hours: M-SA 9AM-5PM present. Hours: M-SA 9AM-5PM
PTA: No PTA: No
Other Language: Arabic, Other Language: Spanish
Spanish Lozada-pastorio, Elizabeth MD Cultural Competency: NR
Cultural Competency: NR 340 4th Ave Ste 4 Accessibility: B; Members
Accessibility: B; Members Chula Vista, CA 91910 should call the provider’s
should call the provider’s (619) 427-1144 office to discuss their
office to discuss their Provider ID: 268556 accessibility needs when there
accessibility needs when there License: A90108 is limited access or when
is limited access or when Credentials and/or board accessibility indicators are not
accessibility indicators are not certification: No present.
present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes Meyer, Jill MD
Khaing, Kathy MD Other Language: Spanish 340 4th Ave Ste 4
340 4th Ave Ste 4 Cultural Competency: NR Chula Vista, CA 91910
Chula Vista, CA 91910 Accessibility: B; Members (619) 427-1144
(619) 427-1144 should call the provider’s Provider ID: 268563
Provider ID: 205003 office to discuss their License: A95882
License: A127006 accessibility needs when there Credentials and/or board
Credentials and/or board is limited access or when certification: Yes
certification: No accessibility indicators are not Accepting New Members: Yes
Accepting New Members: Yes present. Hours: M-SA 9AM-5PM
Hours: M-SA 9AM-5PM PTA: Yes
PTA: No Other Language: Spanish
Other Language: Burmese, Lozada-pastorio, Elizabeth MD Cultural Competency: NR
Spanish 340 Fourth Ave Ste 14 Accessibility: B, W; Members
Cultural Competency: NR Chula Vista, CA 91910 should call the provider’s
Accessibility: B; Members (619) 427-1144 office to discuss their
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 107
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
accessibility needs when there Credentials and/or board accessibility indicators are not
is limited access or when certification: No present.
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM
PTA: No Yuan, Henry MD
Other Language: Spanish 340 Fourth Ave Ste 4
Patel, Amar MD Cultural Competency: NR Chula Vista, CA 91910
340 Fourth Ave Ste 4 Accessibility: B; Members (619) 427-1144
Chula Vista, CA 91910 should call the provider’s Provider ID: 268551
(858) 810-8000 office to discuss their License: A120403
Provider ID: 245639 accessibility needs when there Credentials and/or board
License: A158295 is limited access or when certification: Yes
Credentials and/or board accessibility indicators are not Accepting New Members: Yes
certification: No present. Hours: M-SA 9AM-5PM
Accepting New Members: Yes PTA: No
Hours: M-SA 9AM-5PM Other Language: Chinese,
PTA: No Soltero, Ricardo MD Mandarin, Spanish
Other Language: Gujarati 340 4th Ave Ste 4 Cultural Competency: NR
Cultural Competency: NR Chula Vista, CA 91910 Accessibility: B; Members
Accessibility: B; Members (619) 427-1144 should call the provider’s
should call the provider’s Provider ID: 268490 office to discuss their
office to discuss their License: A68995 accessibility needs when there
accessibility needs when there Credentials and/or board is limited access or when
is limited access or when certification: Yes accessibility indicators are not
accessibility indicators are not Accepting New Members: Yes present.
present. Hours: M-SA 9AM-5PM Special Expertise: HIV/AIDS
PTA: Yes
Other Language: Spanish 91911 Soltero, Ricardo MD Cultural Competency: NR
340 Fourth Ave Ste 14 Accessibility: B; Members Meyer, Jill MD
Chula Vista, CA 91910 should call the provider’s 752 Medical Center Ct Ste 302
(619) 427-1144 office to discuss their Chula Vista, CA 91911
Provider ID: 26526 accessibility needs when there (619) 421-3361
License: A68995 is limited access or when Provider ID: 65487
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 108
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
License: A95882 is limited access or when certification: No
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Soltero, Ricardo MD
752 Medical Center Ct Ste 302
Chula Vista, CA 91911
(619) 421-3361
Provider ID: 268491
License: A68995
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
accessibility indicators are not
present.
Videen, John MD
752 Medical Center Ct Ste 302
Chula Vista, CA 91911
(619) 421-3361
Provider ID: 65646
License: G59271
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Vyas, Dhwanil MD
752 Medical Center Ct Ste 302
Chula Vista, CA 91911
(619) 421-3361
Provider ID: 106551
License: A125364
Credentials and/or board
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Gujarati,
Hindi, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CORONADO
92118
Davis, Jason MD
230 Prospect Pl Ste 340b
Coronado, CA 92118
(619) 299-2350
Provider ID: 270966
License: A100799
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 109
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ENCINITAS
92024
Boiskin, Mark MD
320 Santa Fe Dr Ste 212
Encinitas, CA 92024
(858) 558-8150
Provider ID: 273106
License: A52055
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Afrikaans,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Steer, Dylan MD
320 Santa Fe Dr Ste 212
Encinitas, CA 92024
(760) 509-1040
Provider ID: 272853
License: A65604
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Torosian, Karo DO
320 Santa Fe Dr Ste 212
Encinitas, CA 92024
(858) 558-8150
Provider ID: 272858
License: 20A12445
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Armenian,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Greenstein, Joshua MD
631 E Grand Ave
Escondido, CA 92025
(760) 294-1660
Provider ID: 53809
License: A68100
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hebreo, Joseph MD
631 E Grand Ave
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 110
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Escondido, CA 92025 Other Language: Arabic Neyaz, Mohammed DO
(760) 294-1660 Cultural Competency: NR 631 E Grand Ave
Provider ID: 108435 Accessibility: B; Members Escondido, CA 92025
License: A93436 should call the provider’s (760) 294-1660
Credentials and/or board office to discuss their Provider ID: 108420
certification: Yes accessibility needs when there License: 20A13534
Accepting New Members: Yes is limited access or when Credentials and/or board
Hours: M-SA 9AM-5PM accessibility indicators are not certification: No
PTA: No present. Accepting New Members: Yes
Other Language: Spanish, Hours: M-SA 9AM-5PM
Tagalog PTA: No
Cultural Competency: NR Khawar, Osman MD Other Language: Hindi,
Accessibility: B; Members 631 E Grand Ave Spanish, Urdu
should call the provider’s Escondido, CA 92025 Cultural Competency: NR
office to discuss their (760) 294-1660 Accessibility: B; Members
accessibility needs when there Provider ID: 53715 should call the provider’s
is limited access or when License: A92165 office to discuss their
accessibility indicators are not Credentials and/or board accessibility needs when there
present. certification: No is limited access or when
Accepting New Members: Yes accessibility indicators are not
Hours: M-SA 9AM-5PM present.
Kayal, Anas MD PTA: No
Contract terminated as of Other Language: Spanish,
6/30/2021 Urdu Shapiro, Mark MD
631 E Grand Ave Cultural Competency: NR Contract terminated as of
Escondido, CA 92025 Accessibility: B; Members 8/31/2021
(760) 294-1660 should call the provider’s 631 E Grand Ave
Provider ID: 269211 office to discuss their Escondido, CA 92025
License: A112450 accessibility needs when there (760) 294-1660
Credentials and/or board is limited access or when Provider ID: 275625
certification: No accessibility indicators are not License: G65280
Accepting New Members: No present. Credentials and/or board
Hours: M-SA 9AM-5PM certification: No
PTA: No Accepting New Members: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 111
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Swahili
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Shapiro, Mark MD
Future Effective as of 9/1/2021
631 E Grand Ave
Escondido, CA 92025
(760) 294-1660
Provider ID: 275625
License: G65280
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Swahili
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Boiskin, Mark MD
9834 Genesee Ave Ste 312
La Jolla, CA 92037
(858) 558-8150
Provider ID: 40762
License: A52055
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Afrikaans,
Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Lakhera, Yogita MD
9834 Genesee Ave Ste 312
La Jolla, CA 92037
(858) 558-8150
Provider ID: 109353
License: A125173
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Hindi
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Steer, Dylan MD
9834 Genesee Ave Ste 312
La Jolla, CA 92037
(858) 558-8150
Provider ID: 31399
License: A65604
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 112
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
is limited access or when Provider ID: 43077 office to discuss their
accessibility indicators are not
present.
Torosian, Karo DO
9834 Genesee Ave Ste 312
La Jolla, CA 92037
(858) 558-8150
Provider ID: 269269
License: 20A12445
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Armenian,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Do, Luan MD
8851 Center Dr Ste 505
La Mesa, CA 91942
(619) 461-3880
License: A65161
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Fadda, George MD
8851 Center Dr Ste 505
La Mesa, CA 91942
(619) 461-3880
Provider ID: 26465
License: A44918
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
French
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Miller, Lucy MD
8851 Center Dr Ste 505
La Mesa, CA 91942
(619) 461-3880
Provider ID: 26595
License: A53843
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Japanese,
Portuguese, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Thompson, John MD
8851 Center Dr Ste 505
La Mesa, CA 91942
(619) 461-3880
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 113
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Provider ID: 24866
License: G83902
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Calderon Molina, Juan MD
655 Euclid Ave Ste 303
National City, CA 91950
(619) 585-4370
Provider ID: 109336
License: C143845
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: German,
Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Maa Chip, Fharak MD
655 Euclid Ave Ste 303
National City, CA 91950
(619) 475-4900
Provider ID: 84000
License: A117604
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sacamay, Tagumpay MD
655 Euclid Ave Ste 303
National City, CA 91950
(619) 475-4900
Provider ID: 26710
License: A62631
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
OCEANSIDE
92056
Barager, Richard MD
3300 Vista Way Ste B
Oceanside, CA 92056
(760) 967-9900
Provider ID: 65959
License: G52074
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 114
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Kharadjian, Talar MD
3300 Vista Way Ste B
Oceanside, CA 92056
(760) 967-9900
Provider ID: 279811
License: A161276
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Armenian
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Kyaw, Naing MD
3300 Vista Way
Oceanside, CA 92056
(760) 967-9900
Provider ID: 269374
License: A97469
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Burmese,
Chinese, Mandarin, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Matayoshi, Amy MD
3300 Vista Way Ste B
Oceanside, CA 92056
(760) 967-9900
Provider ID: 54126
License: A60790
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92102
Quevedo, Juan MD
995 Gateway Center Way Ste
207
San Diego, CA 92102
(619) 263-9729
Provider ID: 269998
License: A144881
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 115
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
PTA: No92103 Other Language: Spanish Nguyen, Viet MD
Baranski, Joel MD Cultural Competency: NR 4060 4th Ave Ste 220
4060 4th Ave Ste 220 Accessibility: B; Members San Diego, CA 92103
San Diego, CA 92103 should call the provider’s (619) 299-2350
(619) 299-2350 office to discuss their Provider ID: 270191
Provider ID: 31396 accessibility needs when there License: A149088
License: G67559 is limited access or when Credentials and/or board
Credentials and/or board accessibility indicators are not certification: No
certification: No present. Accepting New Members: Yes
Accepting New Members: Yes Hours: M-SA 9AM-5PM
Hours: M-SA 9AM-5PM PTA: No
PTA: Yes Hammes, John MD Cultural Competency: NR
Other Language: Spanish 4060 Fourth Ave Ste 220 Accessibility: B; Members
Cultural Competency: NR San Diego, CA 92103 should call the provider’s
Accessibility: B, W; Members (619) 299-2350 office to discuss their
should call the provider’s Provider ID: 76487 accessibility needs when there
office to discuss their License: G84351 is limited access or when
accessibility needs when there Credentials and/or board accessibility indicators are not
is limited access or when certification: No present.
accessibility indicators are not Accepting New Members: No
present. Hours: M-SA 9AM-5PM
PTA: No Thomas, Theodore MD
Other Language: French, Contract terminated as of
Davis, Jason MD Spanish 8/31/2021
4060 Fourth Ave Ste 220 Cultural Competency: NR 4060 4th Ave Ste 220
San Diego, CA 92103 Accessibility: B; Members San Diego, CA 92103
(619) 299-2350 should call the provider’s (619) 299-2350
Provider ID: 80404 office to discuss their Provider ID: 26486
License: A100799 accessibility needs when there License: G61681
Credentials and/or board is limited access or when Credentials and/or board
certification: No accessibility indicators are not certification: Yes
Accepting New Members: Yes present. Accepting New Members: No
Hours: M-SA 9AM-5PM Hours: M-SA 9AM-5PM
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 116
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92115
Behrend, Terry MD
6402 El Cajon Blvd Ste 100
San Diego, CA 92115
(619) 582-4490
Provider ID: 87090
License: A75812
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Namazy, David MD
6402 El Cajon Blvd Ste 100
San Diego, CA 92115
(858) 810-8092
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
Provider ID: 258028
License: A74630
accessibility needs when there
is limited access or when
Credentials and/or board accessibility indicators are not
certification: No
Accepting New Members: Yes
present.
Hours: M-SA 9AM-5PM
PTA: No Boiskin, Mark MD
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
9610 Granite Ridge Dr Ste B
San Diego, CA 92123
(858) 810-8000
Provider ID: 269490
office to discuss their License: A52055
accessibility needs when there
is limited access or when
Credentials and/or board
certification: No
accessibility indicators are not
present.
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
92123
Behrend, Terry MD
7910 Frost St Ste 220
San Diego, CA 92123
(858) 637-4700
Provider ID: 244798
License: A75812
Other Language: Afrikaans,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
accessibility indicators are not
present.
PTA: No Chongkrairatanakul, Tepsiri
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 117
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
MD Other Language: German, Faravardeh, Arman MD
8010 Frost St Ste 510 Spanish, Tagalog 8010 Frost St Ste 510
San Diego, CA 92123 Cultural Competency: NR San Diego, CA 92123
(858) 637-4700 Accessibility: B; Members (858) 637-4800
Provider ID: 269868 should call the provider’s Provider ID: 82852
License: C157995 office to discuss their License: A94375
Credentials and/or board accessibility needs when there Credentials and/or board
certification: No is limited access or when certification: No
Accepting New Members: Yes accessibility indicators are not Accepting New Members: Yes
Hours: M-SA 9AM-5PM present. Hours: M-SA 9AM-5PM
PTA: No PTA: No
Other Language: Thai Other Language: Farsi,
Cultural Competency: NR Davis, Jason MD Swedish
Accessibility: B; Members 7910 Frost St Ste 250 Cultural Competency: NR
should call the provider’s San Diego, CA 92123 Accessibility: B; Members
office to discuss their (858) 637-4800 should call the provider’s
accessibility needs when there Provider ID: 270967 office to discuss their
is limited access or when License: A100799 accessibility needs when there
accessibility indicators are not Credentials and/or board is limited access or when
present. certification: No accessibility indicators are not
Accepting New Members: Yes present.
Hours: M-SA 9AM-5PM
Calderon Molina, Juan MD PTA: No
9610 Granite Ridge Dr Ste B Other Language: Spanish Khaing, Kathy MD
San Diego, CA 92123 Cultural Competency: NR 8010 Frost St Ste 510
(619) 475-4900 Accessibility: B; Members San Diego, CA 92123
Provider ID: 270710 should call the provider’s (858) 637-4700
License: C143845 office to discuss their Provider ID: 205002
Credentials and/or board accessibility needs when there License: A127006
certification: No is limited access or when Credentials and/or board
Accepting New Members: Yes accessibility indicators are not certification: No
Hours: M-SA 9AM-5PM present. Accepting New Members: Yes
PTA: No Hours: M-SA 9AM-5PM
PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 118
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Other Language: Burmese, Cultural Competency: NR
Spanish Namazy, David MD Accessibility: B; Members
Cultural Competency: NR 7910 Frost St Ste 220 should call the provider’s
Accessibility: B; Members San Diego, CA 92123 office to discuss their
should call the provider’s (858) 637-4700 accessibility needs when there
office to discuss their Provider ID: 258027 is limited access or when
accessibility needs when there License: A74630 accessibility indicators are not
is limited access or when Credentials and/or board present.
accessibility indicators are not certification: Yes
present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM Shapiro, Mark MD
PTA: No Contract terminated as of
Lund, Guy MD Other Language: Spanish 8/31/2021
8010 Frost St Ste 510 Cultural Competency: NR 9610 Granite Ridge Dr Ste B
San Diego, CA 92123 Accessibility: B; Members San Diego, CA 92123
(858) 637-4700 should call the provider’s (858) 810-8000
Provider ID: 87088 office to discuss their Provider ID: 270972
License: A68839 accessibility needs when there License: G65280
Credentials and/or board is limited access or when Credentials and/or board
certification: No accessibility indicators are not certification: No
Accepting New Members: Yes present. Accepting New Members: No
Hours: M-SA 9AM-5PM Hours: M-SA 9AM-5PM
PTA: No PTA: No
Other Language: Slovak, Patel, Bijal MD Other Language: Spanish,
Spanish 8010 Frost St Ste 510 Swahili
Cultural Competency: NR San Diego, CA 92123 Cultural Competency: NR
Accessibility: B; Members (858) 637-4800 Accessibility: B; Members
should call the provider’s Provider ID: 34506 should call the provider’s
office to discuss their License: A74638 office to discuss their
accessibility needs when there Credentials and/or board accessibility needs when there
is limited access or when certification: No is limited access or when
accessibility indicators are not Accepting New Members: Yes accessibility indicators are not
present. Hours: M-SA 9AM-5PM present.
PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 119
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Steinberg, Steven MD
7910 Frost St Ste 250
San Diego, CA 92123
(858) 637-4800
Provider ID: 270031
License: G17843
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Steinberg, Steven MD
8010 Frost St Ste 510
San Diego, CA 92123
(858) 637-4700
Provider ID: 87140
License: G17843
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Neurology
CARLSBAD
92011
Blumenfeld, Andrew MD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 25914
License: A47863
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Choudry, Bilal MD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 85292
License: A114607
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Urdu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Delaney, Michael MD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-6000
Provider ID: 269103
License: C146015
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 120
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
PTA: No 6010 Hidden Valley Rd Ste 200 Accessibility: B; Members
Other Language: Spanish Carlsbad, CA 92011 should call the provider’s
Cultural Competency: NR (760) 631-3000 office to discuss their
Accessibility: B; Members Provider ID: 65471 accessibility needs when there
should call the provider’s License: G43493 is limited access or when
office to discuss their Credentials and/or board accessibility indicators are not
accessibility needs when there certification: Yes present.
is limited access or when Accepting New Members: Yes
accessibility indicators are not Hours: M-SA 9AM-5PM
present. PTA: No Gualberto, Gary MD
Other Language: Spanish 6010 Hidden Valley Rd Ste 200
Cultural Competency: NR Carlsbad, CA 92011
Desadier, Laura DO Accessibility: B; Members (760) 631-3000
6010 Hidden Valley Rd Ste 200 should call the provider’s Provider ID: 103158
Carlsbad, CA 92011 office to discuss their License: C138319
(760) 631-3000 accessibility needs when there Credentials and/or board
Provider ID: 242451 is limited access or when certification: No
License: 20A14045 accessibility indicators are not Accepting New Members: Yes
Credentials and/or board present. Hours: M-SA 9AM-5PM
certification: No PTA: No
Accepting New Members: Yes Other Language: Spanish
Hours: M-SA 9AM-5PM Gokaldas, Reshma MD Cultural Competency: NR
PTA: No 6010 Hidden Valley Rd Ste 200 Accessibility: B; Members
Cultural Competency: NR Carlsbad, CA 92011 should call the provider’s
Accessibility: B; Members (760) 631-3000 office to discuss their
should call the provider’s Provider ID: 108460 accessibility needs when there
office to discuss their License: A138459 is limited access or when
accessibility needs when there Credentials and/or board accessibility indicators are not
is limited access or when certification: No present.
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM
PTA: No Lobatz, Michael MD
Other Language: Spanish 6010 Hidden Valley Rd Ste 200
Frishberg, Benjamin MD Cultural Competency: NR Carlsbad, CA 92011
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 121
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
(760) 631-3000 office to discuss their License: 20A11494
Provider ID: 52424 accessibility needs when there Credentials and/or board
License: G38353 is limited access or when certification: No
Credentials and/or board accessibility indicators are not Accepting New Members: Yes
certification: No present. Hours: M-SA 9AM-5PM
Accepting New Members: Yes PTA: No
Hours: M-SA 9AM-5PM Other Language: Spanish
PTA: No Lawler, Abigail MD Cultural Competency: NR
Other Language: Hebrew, 6010 Hidden Valley Rd Ste 200 Accessibility: B; Members
Spanish Carlsbad, CA 92011 should call the provider’s
Cultural Competency: NR (760) 631-3000 office to discuss their
Accessibility: B; Members Provider ID: 124983 accessibility needs when there
should call the provider’s License: A152080 is limited access or when
office to discuss their Credentials and/or board accessibility indicators are not
accessibility needs when there certification: No present.
is limited access or when Accepting New Members: Yes
accessibility indicators are not Hours: M-SA 9AM-5PM
present. PTA: No Oh, Irene MD
Other Language: Spanish 6010 Hidden Valley Rd Ste 200
Cultural Competency: NR Carlsbad, CA 92011
Lane, Richard MD Accessibility: B; Members (760) 631-3000
6010 Hidden Valley Rd Ste 200 should call the provider’s Provider ID: 52430
Carlsbad, CA 92011 office to discuss their License: A106450
(760) 631-3000 accessibility needs when there Credentials and/or board
Provider ID: 276889 is limited access or when certification: No
License: A160001 accessibility indicators are not Accepting New Members: Yes
Credentials and/or board present. Hours: M-SA 9AM-5PM
certification: No PTA: No
Accepting New Members: Yes Other Language: Spanish
Hours: M-SA 9AM-5PM Nielsen, Amy DO Cultural Competency: NR
PTA: No 6010 Hidden Valley Rd Ste 200 Accessibility: B; Members
Cultural Competency: NR Carlsbad, CA 92011 should call the provider’s
Accessibility: B; Members (760) 631-3000 office to discuss their
should call the provider’s Provider ID: 74893 accessibility needs when there
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 122
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
is limited access or when
accessibility indicators are not
present.
Omuro, Arthur DO
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 276907
License: 20A15164
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Paduga, Remia MD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 57065
License: A113451
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Pham, Alise DO
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 276490
License: 20A18259
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Quesnell, Tara DO
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 109393
License: 20A13609
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rosenberg, Jay MD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 31935
License: G17059
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 123
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
PTA: No Sahagian, Gregory MD Cultural Competency: NR
Other Language: Spanish 6010 Hidden Valley Rd Ste 200 Accessibility: B; Members
Cultural Competency: NR Carlsbad, CA 92011 should call the provider’s
Accessibility: B; Members (760) 631-3000 office to discuss their
should call the provider’s Provider ID: 65995 accessibility needs when there
office to discuss their License: A62263 is limited access or when
accessibility needs when there Credentials and/or board accessibility indicators are not
is limited access or when certification: No present.
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM
PTA: No Wang, Anchi MD
Other Language: Spanish 6010 Hidden Valley Rd Ste 200
Sadoff, Mark MD Cultural Competency: NR Carlsbad, CA 92011
6010 Hidden Valley Rd Ste 200 Accessibility: B; Members (760) 631-3000
Carlsbad, CA 92011 should call the provider’s Provider ID: 52465
(760) 631-3000 office to discuss their License: A79381
Provider ID: 40012 accessibility needs when there Credentials and/or board
License: G42818 is limited access or when certification: No
Credentials and/or board accessibility indicators are not Accepting New Members: Yes
certification: Yes present. Hours: M-SA 9AM-5PM
Accepting New Members: Yes PTA: No
Hours: M-SA 9AM-5PM Other Language: Mandarin,
PTA: No Schim, Jack MD Spanish
Other Language: Spanish 6010 Hidden Valley Rd Ste 200 Cultural Competency: NR
Cultural Competency: NR Carlsbad, CA 92011 Accessibility: B; Members
Accessibility: B; Members (760) 631-3000 should call the provider’s
should call the provider’s Provider ID: 52446 office to discuss their
office to discuss their License: G48807 accessibility needs when there
accessibility needs when there Credentials and/or board is limited access or when
is limited access or when certification: Yes accessibility indicators are not
accessibility indicators are not Accepting New Members: Yes present.
present. Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish Wang, Chunyang MD
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 124
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 84398
License: A105660
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Mandarin,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CHULA VISTA
91911
Mohammad, Ahmad Shah MD
750 Medical Center Ct Ste 6
Chula Vista, CA 91911
(619) 337-7900
Provider ID: 127244
License: A98831
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Farsi, French, German,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92029
Delaney, Michael MD
1955 Citracado Pkwy Ste 102
Escondido, CA 92029
(760) 631-3000
Provider ID: 269104
License: C146015
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Frishberg, Benjamin MD
1955 Citracado Pkwy Ste 102
Escondido, CA 92029
(760) 631-3000
Provider ID: 76522
License: G43493
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Lawler, Abigail MD
1955 Citracado Pkwy Ste 102
Escondido, CA 92029
(760) 631-3000
Provider ID: 125131
License: A152080
Credentials and/or board
certification: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 125
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Accepting New Members: Yes PTA: No
Hours: M-SA 9AM-5PM Other Language: Spanish
PTA: No Quesnell, Tara DO Cultural Competency: NR
Other Language: Spanish 1955 Citracado Pkwy Ste 102 Accessibility: B; Members
Cultural Competency: NR Escondido, CA 92029 should call the provider’s
Accessibility: B; Members (760) 631-3000 office to discuss their
should call the provider’s Provider ID: 109398 accessibility needs when there
office to discuss their License: 20A13609 is limited access or when
accessibility needs when there Credentials and/or board accessibility indicators are not
is limited access or when certification: No present.
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM
PTA: No Wang, Anchi MD
Other Language: Spanish 1955 Citracado Pkwy Ste 102
Oh, Irene MD Cultural Competency: NR Escondido, CA 92029
1955 Citracado Pkwy Ste 102 Accessibility: B; Members (760) 631-3000
Escondido, CA 92029 should call the provider’s Provider ID: 99281
(760) 631-3000 office to discuss their License: A79381
Provider ID: 76600 accessibility needs when there Credentials and/or board
License: A106450 is limited access or when certification: No
Credentials and/or board accessibility indicators are not Accepting New Members: Yes
certification: No present. Hours: M-SA 9AM-5PM
Accepting New Members: Yes PTA: No
Hours: M-SA 9AM-5PM Other Language: Mandarin,
PTA: No Rosenberg, Jay MD Spanish
Other Language: Spanish 1955 Citracado Pkwy Ste 102 Cultural Competency: NR
Cultural Competency: NR Escondido, CA 92029 Accessibility: B; Members
Accessibility: B; Members (760) 631-3000 should call the provider’s
should call the provider’s Provider ID: 94232 office to discuss their
office to discuss their License: G17059 accessibility needs when there
accessibility needs when there Credentials and/or board is limited access or when
is limited access or when certification: No accessibility indicators are not
accessibility indicators are not Accepting New Members: Yes present.
present. Hours: M-SA 9AM-5PM
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 126
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Wang, Chunyang MD
1955 Citracado Pkwy Ste 102
Escondido, CA 92029
(760) 631-3000
Provider ID: 84403
License: A105660
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Mandarin,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Blumenfeld, Andrew MD
9850 Genesee Ave Ste 505
La Jolla, CA 92037
(760) 631-3000
Provider ID: 277503
License: A47863
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Nielsen, Amy DO
9850 Genesee Ave Ste 530
La Jolla, CA 92037
(760) 631-3000
Provider ID: 277009
License: 20A11494
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Mohammad, Ahmad Shah MD
8851 Center Dr Ste 307
La Mesa, CA 91942
(619) 337-7900
Provider ID: 39868
License: A98831
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic,
Farsi, French, German,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Blumenfeld, Andrew MD
15611 Pomerado Rd Ste 505
Poway, CA 92064
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 127
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
(760) 631-3000
Provider ID: 268086
License: A47863
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Delaney, Michael MD
15721 Pomerado Rd
Poway, CA 92064
(760) 631-3000
Provider ID: 269105
License: C146015
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Delaney, Michael MD
15611 Pomerado Rd Ste 505
Poway, CA 92064
(760) 631-3000
Provider ID: 272331
License: C146015
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Wang, Chunyang MD
15611 Pomerado Rd Ste 505
Poway, CA 92064
(760) 631-3000
Provider ID: 268120
License: A105660
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Mandarin,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92120
Khamishon, Boris MD
6699 Alvarado Rd Ste 2301
San Diego, CA 92120
(619) 582-2595
Provider ID: 269923
License: A56165
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 128
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92123
Shapiro, Mark MD
Future Effective as of 9/1/2021
9610 Granite Ridge Dr Ste B
San Diego, CA 92123
(858) 810-8000
Provider ID: 270972
License: G65280
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Swahili
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92128
Schumann, Richard MD
16776 Bernardo Center Dr Ste
209
San Diego, CA 92128
(858) 675-1112
Provider ID: 269967
License: A62324
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Nuclear Medicine
92123
Evans, David MD
3444 Kearny Villa Rd Ste 201
San Diego, CA 92123
(858) 430-1101
Provider ID: 129554
License: G55686
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Kipper, Michael MD
5395 Ruffin Rd Ste 202
San Diego, CA 92123
(858) 569-7899
Provider ID: 119551
License: A24718
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Obstetrics / Gynecology
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 129
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
CHULA VISTA
91911
Anguiano, Francisco MD
765 Medical Center Ct Ste 209
Chula Vista, CA 91911
(619) 427-8892
Provider ID: 268797
License: G61584
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Atiga, Schubert MD
752 Medical Center Ct Ste 106
Chula Vista, CA 91911
(619) 482-8406
Provider ID: 268953
License: G53756
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
EL CAJON
92021
Bukowski, Kyle MD
1685 E Main St Ste 301
El Cajon, CA 92021
(310) 825-9945
Provider ID: 269037
License: A133994
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Chiarappa, Ashley MD
488 E Valley Pkwy Ste 310
Escondido, CA 92025
(760) 745-7060
Provider ID: 269149
License: A164036
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Cizmar, Branislav MD
488 E Valley Pkwy Ste 311
Escondido, CA 92025
(760) 233-1896
Provider ID: 54052
License: A80606
Credentials and/or board
certification: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 130
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Italian,
Slovak, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Cizek, Stephanie MD
347 W Mission Ave
Escondido, CA 92025
(415) 833-9183
Provider ID: 269235
License: A135224
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hinshaw, Paul DO
426 N Date St
Escondido, CA 92025
(760) 690-5900
Provider ID: 269223
License: 20A13379
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Alvarado, Jorge MD
9300 Campus Point Dr
La Jolla, CA 92037
(858) 657-7000
Provider ID: 269564
License: A139473
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Su, Hui Chun MD
9350 Campus Point Dr Ste Llc
La Jolla, CA 92037
(858) 657-8745
Provider ID: 269338
License: A110340
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Mandarin
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 131
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
certification: No present.91950
Del Rosario, Gelen MD
502 Euclid Ave Ste 300
National City, CA 91950
(619) 475-1261
Provider ID: 269247
License: A113471
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92103
Frugoni, Gina MD
4168 Front St
San Diego, CA 92103
(619) 543-7878
Provider ID: 270056
License: A99646
Credentials and/or board
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Herrero, Tiffany MD
200 W Arbor Dr
San Diego, CA 92103
(650) 243-7942
Provider ID: 270001
License: A119846
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Mandarin,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
92108
Nguyen, Son MD
1075 Camino Del Rio S
San Diego, CA 92108
(619) 881-4500
Provider ID: 271018
License: G63695
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Priver, David MD
1075 Camino Del Rio S
San Diego, CA 92108
(619) 280-4213
Provider ID: 271005
License: C38171
Credentials and/or board
certification: No
Accepting New Members: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 132
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92114
Moran, Thomas MD
220 Euclid Ave Ste 30
San Diego, CA 92114
(619) 881-4500
Provider ID: 270953
License: G59541
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92123
Mansour, Anmar MD
7695 Cardinal Ct Ste 370
San Diego, CA 92123
(858) 277-1599
Provider ID: 204717
License: A92470
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Occupational Therapist
CHULA VISTA
91910
Morris, Sheila OT
1020 Tierra Del Rey Ste A-1
Chula Vista, CA 91910
(619) 585-7104
Provider ID: 268926
License: OT15057
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92121
Manecke, Kristen OT
9333 Genesee Ave Ste 350b
San Diego, CA 92121
(858) 455-6460
Provider ID: 269897
License: OT2537
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 133
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Oncology Medical
ENCINITAS
92024
Frakes, Laurie MD
477 N El Camino Real Ste C204
Encinitas, CA 92024
(760) 452-3340
Provider ID: 269133
License: A52663
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mcclay, Edward MD
477 N El Camino Real Ste D200
Encinitas, CA 92024
(760) 452-3340
Provider ID: 243933
License: G64594
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Sinclair, James MD
9850 Genesee Ave Ste 560
La Jolla, CA 92037
(858) 552-1410
Provider ID: 257002
License: G48926
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92127
Frakes, Laurie MD
16918 Dove Canyon Rd Ste
103
San Diego, CA 92127
(858) 649-5100
Provider ID: 241857
License: A52663
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN MARCOS
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 134
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
PTA: No92069 91901
Frakes, Laurie MD
838 Nordahl Rd Ste 300
San Marcos, CA 92069
(760) 747-8935
Provider ID: 269134
License: A52663
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mcclay, Edward MD
838 Nordahl Rd Ste 300
San Marcos, CA 92069
(760) 747-8935
Provider ID: 243932
License: G64594
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sinclair, James MD
838 Nordahl Rd Ste 300
San Marcos, CA 92069
(760) 474-8935
Provider ID: 257003
License: G48926
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Ophthalmology
ALPINE
Binder, Nicholas MD
1620 Alpine Blvd Ste 117
Alpine, CA 91901
(619) 445-2687
Provider ID: 268753
License: A124698
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Chang, Tom MD
1620 Alpine Blvd Ste 117
Alpine, CA 91901
(800) 897-2020
Provider ID: 270362
License: A69909
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 135
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Other Language: Arabic, accessibility needs when there Provider ID: 268803
Armenian, Cantonese, is limited access or when License: A114976
Croatian, Korean, Mandarin, accessibility indicators are not Credentials and/or board
Spanish, Tagalog present. certification: No
Cultural Competency: NR Accepting New Members: Yes
Accessibility: B; Members Hours: M-SA 9AM-5PM
should call the provider’s Patel, Gitane MD PTA: No
office to discuss their 1620 Alpine Blvd Ste 117 Other Language: Gujarati,
accessibility needs when there Alpine, CA 91901 Hindi, Spanish, Tagalog,
is limited access or when (800) 898-2020 Vietnamese
accessibility indicators are not Provider ID: 268739 Cultural Competency: NR
present. License: A108603 Accessibility: B; Members
Special Expertise: Deafness or Credentials and/or board should call the provider’s
Hard-of-Hearing, Co-occuring certification: No office to discuss their
Disorders Accepting New Members: Yes accessibility needs when there
Hours: M-SA 9AM-5PM is limited access or when
PTA: Yes accessibility indicators are not
Miller, Douglas MD Other Language: Arabic, present.
1620 Alpine Blvd Ste 117 Gujarati, Spanish, Tagalog,
Alpine, CA 91901 Vietnamese
(619) 445-2687 Cultural Competency: NR Prabhu, Sujata MD
Provider ID: 268957 Accessibility: B; Members 1620 Alpine Blvd Ste 117
License: G52627 should call the provider’s Alpine, CA 91901
Credentials and/or board office to discuss their (619) 445-2687
certification: No accessibility needs when there Provider ID: 268918
Accepting New Members: Yes is limited access or when License: A115965
Hours: M-SA 9AM-5PM accessibility indicators are not Credentials and/or board
PTA: No present. certification: No
Other Language: Spanish, Accepting New Members: Yes
Tagalog, Vietnamese Hours: M-SA 9AM-5PM
Cultural Competency: NR Patel, Sarjan MD PTA: No
Accessibility: B; Members 1620 Alpine Blvd Ste 117 Other Language: Spanish,
should call the provider’s Alpine, CA 91901 Tagalog, Telugu, Vietnamese
office to discuss their (619) 445-2687 Cultural Competency: NR
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 136
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Wainess, Reid MD
1620 Alpine Blvd Ste 117
Alpine, CA 91901
(800) 898-2020
Provider ID: 254761
License: A108766
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Armenian,
Cantonese, Hebrew,
Mandarin, Spanish,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CHULA VISTA
91910
Bryant, Duane MD
342 F St
Chula Vista, CA 91910
(619) 422-1471
Provider ID: 244753
License: C155562
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Castillejos-rios, David MD
342 F St
Chula Vista, CA 91910
(619) 422-1471
Provider ID: 268782
License: A44482
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Castillejos, Maria MD
342 F St
Chula Vista, CA 91910
(619) 422-1471
Provider ID: 268747
License: A37652
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Goldman, Ronald MD
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 137
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
480 4th Ave Ste 201 Cultural Competency: NR
Chula Vista, CA 91910 Accessibility: B; Members
(619) 427-3355 should call the provider’s
Provider ID: 26488 office to discuss their
License: C27512 accessibility needs when there
Credentials and/or board is limited access or when
certification: Yes accessibility indicators are not
Accepting New Members: Yes present.
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish, Vadoothker, Saujanya MD
Tagalog 480 4th Ave Ste 201
Cultural Competency: NR Chula Vista, CA 91910
Accessibility: B; Members (619) 427-3355
should call the provider’s Provider ID: 268635
office to discuss their License: A156489
accessibility needs when there Credentials and/or board
is limited access or when certification: No
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Scher, Barry MD Tagalog
480 Fourth Ave Ste 201 Cultural Competency: NR
Chula Vista, CA 91910 Accessibility: B; Members
(619) 427-3355 should call the provider’s
Provider ID: 268828 office to discuss their
License: G23827 accessibility needs when there
Credentials and/or board is limited access or when
certification: No accessibility indicators are not
Accepting New Members: Yes present.
Hours: M-SA 9AM-5PM
PTA: No 91911 Other Language: Spanish
Carraby, Arnett MD
835 Third Ave Ste A
Chula Vista, CA 91911
(619) 425-7755
Provider ID: 103061
License: G47836
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Chavez, Cesar MD
835 Third Ave Ste A
Chula Vista, CA 91911
(619) 425-7755
Provider ID: 268776
License: G51615
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 138
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Other Language: Spanish PTA: No
Cultural Competency: NR Echegoyen, Julio MD Other Language: Farsi,
Accessibility: B; Members 835 3rd Ave Ste A Spanish
should call the provider’s Chula Vista, CA 91911 Cultural Competency: NR
office to discuss their (619) 425-7755 Accessibility: B; Members
accessibility needs when there Provider ID: 257137 should call the provider’s
is limited access or when License: A121431 office to discuss their
accessibility indicators are not Credentials and/or board accessibility needs when there
present. certification: Yes is limited access or when
Accepting New Members: Yes accessibility indicators are not
Hours: M-SA 9AM-5PM present.
Delengocky, Tayson DO PTA: No
835 3rd Ave Ste A Other Language: Spanish,
Chula Vista, CA 91911 Tagalog Mani, Hamid MD
(619) 425-7755 Cultural Competency: NR 835 3rd Ave Ste A
Provider ID: 78153 Accessibility: B; Members Chula Vista, CA 91911
License: 20A12784 should call the provider’s (619) 425-7755
Credentials and/or board office to discuss their Provider ID: 269229
certification: Yes accessibility needs when there License: A40472
Accepting New Members: Yes is limited access or when Credentials and/or board
Hours: M-SA 9AM-5PM accessibility indicators are not certification: No
PTA: Yes present. Accepting New Members: Yes
Other Language: Farsi, Hours: M-SA 9AM-5PM
French, Spanish, Tagalog, PTA: No
Vietnamese Khandan, Sara MD Other Language: Arabic,
Cultural Competency: NR 835 Third Ave Ste A Farsi, Spanish
Accessibility: B; Members Chula Vista, CA 91911 Cultural Competency: NR
should call the provider’s (619) 425-7755 Accessibility: B; Members
office to discuss their Provider ID: 268580 should call the provider’s
accessibility needs when there License: A155828 office to discuss their
is limited access or when Credentials and/or board accessibility needs when there
accessibility indicators are not certification: No is limited access or when
present. Accepting New Members: Yes accessibility indicators are not
Hours: M-SA 9AM-5PM present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 139
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Hours: M-SA 9AM-5PM
PTA: Yes
Mani, Majid MD Other Language: Arabic, Papastergiou, Georgios MD
835 3rd Ave Ste A Faroese, Farsi, Spanish 835 3rd Ave Ste A
Chula Vista, CA 91911 Cultural Competency: NR Chula Vista, CA 91911
(619) 425-7755 Accessibility: B; Members (619) 425-7755
Provider ID: 269193 should call the provider’s Provider ID: 269189
License: A60640 office to discuss their License: A127706
Credentials and/or board accessibility needs when there Credentials and/or board
certification: No is limited access or when certification: Yes
Accepting New Members: Yes accessibility indicators are not Accepting New Members: Yes
Hours: M-SA 9AM-5PM present. Hours: M-SA 9AM-5PM
PTA: No PTA: Yes
Other Language: Farsi, Other Language: Arabic,
Spanish Moss, Jason MD Farsi, French, Greek, Italian,
Cultural Competency: NR 835 Third Ave Ste A Spanish
Accessibility: B; Members Chula Vista, CA 91911 Cultural Competency: NR
should call the provider’s (619) 425-7755 Accessibility: B; Members
office to discuss their Provider ID: 106478 should call the provider’s
accessibility needs when there License: A130529 office to discuss their
is limited access or when Credentials and/or board accessibility needs when there
accessibility indicators are not certification: No is limited access or when
present. Accepting New Members: Yes accessibility indicators are not
Hours: M-SA 9AM-5PM present.
PTA: No
Mani, Nasrin MD Other Language: Spanish
835 3rd Ave Ste A Cultural Competency: NR Pons, Mauricio MD
Chula Vista, CA 91911 Accessibility: B; Members 835 3rd Ave Ste A
(619) 425-7755 should call the provider’s Chula Vista, CA 91911
Provider ID: 269199 office to discuss their (619) 425-7755
License: A40473 accessibility needs when there Provider ID: 269242
Credentials and/or board is limited access or when License: A87650
certification: No accessibility indicators are not Credentials and/or board
Accepting New Members: Yes present. certification: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 140
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Peairs, James MD
835 Third Ave Ste A
Chula Vista, CA 91911
(619) 425-7755
Provider ID: 268818
License: A155296
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rajsbaum, Martin MD
835 Third Ave Ste A
Chula Vista, CA 91911
(619) 425-7755
Provider ID: 268749
License: A42670
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Russian, Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sassani, Patrick MD
835 Third Ave Ste A
Chula Vista, CA 91911
(619) 425-7755
Provider ID: 269076
License: A150205
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Scher, Barry MD
835 Third Ave Ste A
Chula Vista, CA 91911
(619) 425-7755
Provider ID: 268830
License: G23827
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 141
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
present. Accepting New Members: Yes present.
Skaf, Ayham MD
835 3rd Ave Ste A
Chula Vista, CA 91911
(619) 425-7755
Provider ID: 269074
License: A120584
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Stainer, Gregory MD
835 Third Ave Ste A
Chula Vista, CA 91911
(619) 425-7755
Provider ID: 272892
License: G41135
Credentials and/or board
certification: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
EL CAJON
92020
Binder, Nicholas MD
450 Fletcher Pkwy Ste 112
El Cajon, CA 92020
(619) 697-4600
Provider ID: 268752
License: A124698
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
Mcgraw, Joseph MD
450 Fletcher Pkwy Ste 112
El Cajon, CA 92020
(800) 898-2020
Provider ID: 269703
License: A155228
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Miller, Douglas MD
450 Fletcher Pkwy Ste 112
El Cajon, CA 92020
(800) 898-2020
Provider ID: 68144
License: G52627
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 142
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
PTA: No present. certification: No
Other Language: Spanish,
Tagalog, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Patel, Gitane MD
450 Fletcher Pkwy Ste 112
El Cajon, CA 92020
(800) 898-2020
Provider ID: 268740
License: A108603
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic,
Gujarati, Spanish, Tagalog,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
Patel, Sarjan MD
450 Fletcher Pkwy Ste 112
El Cajon, CA 92020
(800) 898-2020
Provider ID: 268799
License: A114976
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Gujarati,
Hindi, Spanish, Tagalog,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Prabhu, Sujata MD
450 Fletcher Pkwy Ste 112
El Cajon, CA 92020
(800) 898-2020
Provider ID: 268917
License: A115965
Credentials and/or board
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog, Telugu, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ENCINITAS
92024
Mcgraw, Joseph MD
320 Santa Fe Dr Ste 104
Encinitas, CA 92024
(800) 898-2020
Provider ID: 269706
License: A155228
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 143
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
is limited access or when
accessibility indicators are not
present.
Scotti, Frank MD
320 Santa Fe Dr Ste 104
Encinitas, CA 92024
(760) 943-7141
Provider ID: 255689
License: G40698
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Binder, Nicholas MD
830 W Valley Pkwy Ste 300
Escondido, CA 92025
(800) 898-2020
Provider ID: 268756
License: A124698
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mcgraw, Joseph MD
830 W Valley Pkwy Ste 300
Escondido, CA 92025
(800) 898-2020
Provider ID: 269705
License: A155228
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Miller, Douglas MD
830 W Valley Pkwy Ste 300
Escondido, CA 92025
(760) 743-5872
Provider ID: 268956
License: G52627
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Morrison-reyes, Joshua MD
830 W Valley Pkwy Ste 300
Escondido, CA 92025
(760) 743-5872
Provider ID: 269179
License: A125435
Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 144
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Armenian,
Cantonese, Indonesian,
Mandarin, Spanish, Tagalog,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Patel, Gitane MD
830 W Valley Pkwy Ste 300
Escondido, CA 92025
(760) 743-5872
Provider ID: 268741
License: A108603
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Gujarati, Spanish, Tagalog,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Patel, Sarjan MD
830 W Valley Pkwy Ste 300
Escondido, CA 92025
(800) 898-2020
Provider ID: 268802
License: A114976
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Gujarati,
Hindi, Spanish, Tagalog,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Prabhu, Sujata MD
830 W Valley Pkwy Ste 300
Escondido, CA 92025
(800) 898-2020
Provider ID: 268920
License: A115965
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog, Telugu, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Binder, Nicholas MD
9850 Genesee Ave Ste 310
La Jolla, CA 92037
(800) 898-2020
Provider ID: 268757
License: A124698
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 145
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Chang, Tom MD
9850 Genesee Ave Ste 310
La Jolla, CA 92037
(800) 898-2020
Provider ID: 270366
License: A69909
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Armenian, Cantonese,
Croatian, Korean, Mandarin,
Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Special Expertise: Deafness or
Hard-of-Hearing, Co-occuring
Disorders
Coden, Daniel MD
9850 Genesee Ave Ste 310
La Jolla, CA 92037
(800) 898-2020
Provider ID: 269295
License: G57587
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Gollogly, Heidrun MD
9850 Genesee Ave Ste 310
La Jolla, CA 92037
(800) 898-2020
Provider ID: 269128
License: A134761
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
German, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mcgraw, Joseph MD
9850 Genesee Ave Ste 310
La Jolla, CA 92037
(800) 898-2020
Provider ID: 269707
License: A155228
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 146
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Accepting New Members: Yes accessibility indicators are not
Morrison-reyes, Joshua MD Hours: M-SA 9AM-5PM present.
9850 Genesee Ave Ste 310 PTA: Yes
La Jolla, CA 92037 Other Language: Spanish,
(858) 457-3010 Tagalog Samuel, Michael MD
Provider ID: 269183 Cultural Competency: NR 9850 Genesee Ave Ste 310
License: A125435 Accessibility: B; Members La Jolla, CA 92037
Credentials and/or board should call the provider’s (800) 898-2020
certification: No office to discuss their Provider ID: 268596
Accepting New Members: Yes accessibility needs when there License: A83237
Hours: M-SA 9AM-5PM is limited access or when Credentials and/or board
PTA: No accessibility indicators are not certification: No
Other Language: Armenian, present. Accepting New Members: Yes
Cantonese, Indonesian, Hours: M-SA 9AM-5PM
Mandarin, Spanish, Tagalog, PTA: No
Vietnamese Pratt, Steven MD Other Language: Armenian,
Cultural Competency: NR 9850 Genesee Ave Ste 310 Cantonese, Mandarin,
Accessibility: B; Members La Jolla, CA 92037 Spanish, Vietnamese
should call the provider’s (800) 898-2020 Cultural Competency: NR
office to discuss their Provider ID: 269324 Accessibility: B; Members
accessibility needs when there License: G32379 should call the provider’s
is limited access or when Credentials and/or board office to discuss their
accessibility indicators are not certification: Yes accessibility needs when there
present. Accepting New Members: Yes is limited access or when
Hours: M-SA 9AM-5PM accessibility indicators are not
PTA: Yes present.
Perry, Arthur MD Other Language: Spanish, Special Expertise: Deafness or
9850 Genesee Ave Ste 310 Tagalog, Vietnamese Hard-of-Hearing, Co-occuring
La Jolla, CA 92037 Cultural Competency: NR Disorders
(858) 457-3010 Accessibility: B; Members
Provider ID: 265703 should call the provider’s 92093 License: C37934 office to discuss their
Credentials and/or board accessibility needs when there Echegoyen, Julio MD
certification: Yes is limited access or when 9415 Campus Point Dr
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 147
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
La Jolla, CA 92093
(858) 534-6290
Provider ID: 257136
License: A121431
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Binder, Nicholas MD
5565 Grossmont Center Dr Ste
3 Bldg 2
La Mesa, CA 91942
(619) 697-4600
Provider ID: 268754
License: A124698
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Carraby, Arnett MD
8851 Center Dr Ste 406
La Mesa, CA 91942
(619) 425-7755
Provider ID: 269060
License: G47836
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Chavez, Cesar MD
8851 Center Dr Ste 406
La Mesa, CA 91942
(619) 425-7755
Provider ID: 268778
License: G51615
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Delengocky, Tayson DO
8851 Center Dr Ste 406
La Mesa, CA 91942
(619) 425-7755
Provider ID: 268959
License: 20A12784
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 148
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Other Language: Farsi, certification: No
French, Spanish, Tagalog, Accepting New Members: Yes
Vietnamese Gollogly, Heidrun MD Hours: M-SA 9AM-5PM
Cultural Competency: NR 5565 Grossmont Center Dr Ste PTA: No
Accessibility: B; Members 551 Cultural Competency: NR
should call the provider’s La Mesa, CA 91942 Accessibility: B; Members
office to discuss their (800) 898-2020 should call the provider’s
accessibility needs when there Provider ID: 269127 office to discuss their
is limited access or when License: A134761 accessibility needs when there
accessibility indicators are not Credentials and/or board is limited access or when
present. certification: No accessibility indicators are not
Accepting New Members: Yes present.
Hours: M-SA 9AM-5PM
Echegoyen, Julio MD PTA: No
8851 Center Dr Ste 406 Other Language: French, Ho, Joseph MD
La Mesa, CA 91942 German, Spanish 5565 Grossmont Center Dr Ste
(619) 425-7755 Cultural Competency: NR 3 Bldg 2
Provider ID: 268935 Accessibility: B; Members La Mesa, CA 91942
License: A121431 should call the provider’s (800) 898-2020
Credentials and/or board office to discuss their Provider ID: 268884
certification: No accessibility needs when there License: A137389
Accepting New Members: Yes is limited access or when Credentials and/or board
Hours: M-SA 9AM-5PM accessibility indicators are not certification: No
PTA: No present. Accepting New Members: Yes
Other Language: Spanish, Hours: M-SA 9AM-5PM
Tagalog PTA: No
Cultural Competency: NR Haight, Bruce MD Other Language: Chinese,
Accessibility: B; Members 5565 Grossmont Center Dr Ste Mandarin
should call the provider’s 551 Bldg 3 Cultural Competency: NR
office to discuss their La Mesa, CA 91942 Accessibility: B; Members
accessibility needs when there (619) 465-2020 should call the provider’s
is limited access or when Provider ID: 269112 office to discuss their
accessibility indicators are not License: G41117 accessibility needs when there
present. Credentials and/or board is limited access or when
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 149
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
accessibility indicators are not
present.
Kownacki, John MD
5565 Grossmont Center Dr Ste
551 Bldg 3
La Mesa, CA 91942
(619) 465-2020
Provider ID: 269085
License: G84672
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mani, Hamid MD
8851 Center Dr Ste 406
La Mesa, CA 91942
(619) 425-7755
Provider ID: 269230
License: A40472
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Farsi, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mani, Majid MD
8851 Center Dr Ste 406
La Mesa, CA 91942
(619) 425-7755
Provider ID: 269194
License: A60640
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mani, Nasrin MD
8851 Center Dr Ste 406
La Mesa, CA 91942
(619) 425-7755
Provider ID: 269200
License: A40473
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Faroese, Farsi, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mcgraw, Joseph MD
5565 Grossmont Center Dr Ste
551
La Mesa, CA 91942
(619) 465-2020
Provider ID: 269699
License: A155228
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 150
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Credentials and/or board office to discuss their License: A127706
certification: No accessibility needs when there Credentials and/or board
Accepting New Members: Yes is limited access or when certification: No
Hours: M-SA 9AM-5PM accessibility indicators are not Accepting New Members: Yes
PTA: No present. Hours: M-SA 9AM-5PM
Cultural Competency: NR PTA: No
Accessibility: B; Members Other Language: Arabic,
should call the provider’s Moss, Jason MD Farsi, French, Greek, Italian,
office to discuss their 8851 Center Dr Ste 406 Spanish
accessibility needs when there La Mesa, CA 91942 Cultural Competency: NR
is limited access or when (619) 425-7755 Accessibility: B; Members
accessibility indicators are not Provider ID: 268758 should call the provider’s
present. License: A130529 office to discuss their
Credentials and/or board accessibility needs when there
certification: No is limited access or when
Morrison-reyes, Joshua MD Accepting New Members: Yes accessibility indicators are not
5565 Grossmont Center Dr Ste Hours: M-SA 9AM-5PM present.
551 Bldg 3 PTA: No
La Mesa, CA 91942 Other Language: Spanish
(619) 465-2020 Cultural Competency: NR Pons, Mauricio MD
Provider ID: 269182 Accessibility: B; Members 8851 Center Dr Ste 406
License: A125435 should call the provider’s La Mesa, CA 91942
Credentials and/or board office to discuss their (619) 425-7755
certification: No accessibility needs when there Provider ID: 269243
Accepting New Members: Yes is limited access or when License: A87650
Hours: M-SA 9AM-5PM accessibility indicators are not Credentials and/or board
PTA: No present. certification: No
Other Language: Armenian, Accepting New Members: Yes
Cantonese, Indonesian, Hours: M-SA 9AM-5PM
Mandarin, Spanish, Tagalog, Papastergiou, Georgios MD PTA: No
Vietnamese 8851 Center Dr Ste 406 Other Language: Spanish
Cultural Competency: NR La Mesa, CA 91942 Cultural Competency: NR
Accessibility: B; Members (619) 425-7755 Accessibility: B; Members
should call the provider’s Provider ID: 269191 should call the provider’s
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 151
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
office to discuss their (619) 465-2020 should call the provider’s
accessibility needs when there Provider ID: 269038 office to discuss their
is limited access or when License: C31021 accessibility needs when there
accessibility indicators are not Credentials and/or board is limited access or when
present. certification: Yes accessibility indicators are not
Accepting New Members: Yes present.
Hours: M-SA 9AM-5PM
Peairs, James MD PTA: Yes
8851 Center Dr Ste 406 Other Language: Spanish Scher, Barry MD
La Mesa, CA 91942 Cultural Competency: NR 8851 Center Dr Ste 406
(619) 425-7755 Accessibility: B, W; Members La Mesa, CA 91942
Provider ID: 268820 should call the provider’s (619) 425-7755
License: A155296 office to discuss their Provider ID: 268829
Credentials and/or board accessibility needs when there License: G23827
certification: No is limited access or when Credentials and/or board
Accepting New Members: Yes accessibility indicators are not certification: No
Hours: M-SA 9AM-5PM present. Accepting New Members: Yes
PTA: No Hours: M-SA 9AM-5PM
Other Language: Arabic, PTA: No
Spanish Sassani, Patrick MD Other Language: Spanish
Cultural Competency: NR 8851 Center Dr Ste 406 Cultural Competency: NR
Accessibility: B; Members La Mesa, CA 91942 Accessibility: B; Members
should call the provider’s (619) 425-7755 should call the provider’s
office to discuss their Provider ID: 269077 office to discuss their
accessibility needs when there License: A150205 accessibility needs when there
is limited access or when Credentials and/or board is limited access or when
accessibility indicators are not certification: No accessibility indicators are not
present. Accepting New Members: Yes present.
Hours: M-SA 9AM-5PM
PTA: No
Rice, Lawrence MD Other Language: Arabic, Skaf, Ayham MD
5565 Grossmont Center Dr Ste Spanish, Tagalog 8851 Center Dr Ste 406
551 Cultural Competency: NR La Mesa, CA 91942
La Mesa, CA 91942 Accessibility: B; Members (619) 425-7755
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 152
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Provider ID: 269075
License: A120584
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Wasserstrom, Jeffrey MD
5565 Grossmont Center Dr Ste
551 Bldg 3
La Mesa, CA 91942
(619) 698-1088
Provider ID: 66034
License: G54813
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Zabaneh, Alexander MD
5565 Grossmont Center Dr Ste
551
La Mesa, CA 91942
(800) 898-2020
Provider ID: 269123
License: A154697
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Abdallah, Walid MD
1520 E Plaza Blvd
National City, CA 91950
(619) 425-7755
Provider ID: 266063
License: A146829
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Korean, Mandarin, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Carraby, Arnett MD
1520 E Plaza Blvd
National City, CA 91950
(619) 425-7755
Provider ID: 268383
License: G47836
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 153
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Other Language: Spanish,
Tagalog, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Chang, Tom MD
2240 E Plaza Blvd Ste F G
National City, CA 91950
(800) 898-2020
Provider ID: 270365
License: A69909
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Armenian, Cantonese,
Croatian, Korean, Mandarin,
Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Special Expertise: Deafness or
Hard-of-Hearing, Co-occuring
Disorders
Echegoyen, Julio MD
1520 E Plaza Blvd
National City, CA 91950
(619) 425-7755
Provider ID: 268352
License: A121431
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Gollogly, Heidrun MD
655 Euclid Ave Ste 302
National City, CA 91950
(619) 472-1010
Provider ID: 269126
License: A134761
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
German, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Haight, Bruce MD
655 Euclid Ave Ste 302
National City, CA 91950
(619) 472-1010
Provider ID: 269113
License: G41117
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 154
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
is limited access or when
accessibility indicators are not
present.
Kownacki, John MD
655 Euclid Ave Ste 302
National City, CA 91950
(619) 472-1010
Provider ID: 269086
License: G84672
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Khandan, Sara MD
1520 E Plaza Blvd
National City, CA 91950
(619) 425-7755
Provider ID: 268351
License: A155828
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mani, Majid MD
1520 E Plaza Blvd
National City, CA 91950
(619) 425-7755
Provider ID: 268295
License: A60640
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mani, Nasrin MD
1520 E Plaza Blvd
National City, CA 91950
(619) 425-7755
Provider ID: 269201
License: A40473
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Faroese, Farsi, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mcgraw, Joseph MD
2240 E Plaza Blvd Ste F
National City, CA 91950
(619) 470-2700
Provider ID: 269700
License: A155228
Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 155
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
certification: No PTA: No
Accepting New Members: Yes Miller, Douglas MD Other Language: Spanish,
Hours: M-SA 9AM-5PM 2240 E Plaza Blvd Ste G Tagalog, Vietnamese
PTA: No National City, CA 91950 Cultural Competency: NR
Cultural Competency: NR (619) 470-2700 Accessibility: B; Members
Accessibility: B; Members Provider ID: 268954 should call the provider’s
should call the provider’s License: G52627 office to discuss their
office to discuss their Credentials and/or board accessibility needs when there
accessibility needs when there certification: No is limited access or when
is limited access or when Accepting New Members: Yes accessibility indicators are not
accessibility indicators are not Hours: M-SA 9AM-5PM present.
present. PTA: No
Other Language: Spanish,
Tagalog, Vietnamese Morrison-reyes, Joshua MD
Mcgraw, Joseph MD Cultural Competency: NR 655 Euclid Ave Ste 302
2240 E Plaza Blvd Ste G Accessibility: B; Members National City, CA 91950
National City, CA 91950 should call the provider’s (619) 472-1010
(619) 470-2700 office to discuss their Provider ID: 269180
Provider ID: 269701 accessibility needs when there License: A125435
License: A155228 is limited access or when Credentials and/or board
Credentials and/or board accessibility indicators are not certification: No
certification: No present. Accepting New Members: Yes
Accepting New Members: Yes Hours: M-SA 9AM-5PM
Hours: M-SA 9AM-5PM PTA: No
PTA: No Miller, Douglas MD Other Language: Armenian,
Cultural Competency: NR 2240 E Plaza Blvd Ste F Cantonese, Indonesian,
Accessibility: B; Members National City, CA 91950 Mandarin, Spanish, Tagalog,
should call the provider’s (619) 470-2700 Vietnamese
office to discuss their Provider ID: 268955 Cultural Competency: NR
accessibility needs when there License: G52627 Accessibility: B; Members
is limited access or when Credentials and/or board should call the provider’s
accessibility indicators are not certification: No office to discuss their
present. Accepting New Members: Yes accessibility needs when there
Hours: M-SA 9AM-5PM is limited access or when
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 156
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
accessibility indicators are not License: A130529 office to discuss their
present.
Morrison-reyes, Joshua MD
2240 E Plaza Blvd Ste F And G
National City, CA 91950
(619) 470-2700
Provider ID: 269181
License: A125435
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Armenian,
Cantonese, Indonesian,
Mandarin, Spanish, Tagalog,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Moss, Jason MD
1520 E Plaza Blvd
National City, CA 91950
(619) 425-7755
Provider ID: 268290
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Papastergiou, Georgios MD
1520 E Plaza Blvd
National City, CA 91950
(619) 425-7755
Provider ID: 268327
License: A127706
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Farsi, French, Greek, Italian,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Patel, Gitane MD
2240 E Plaza Blvd Ste F And G
National City, CA 91950
(619) 470-2700
Provider ID: 268742
License: A108603
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Gujarati, Spanish, Tagalog,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Patel, Sarjan MD
2240 E Plaza Blvd Ste F And G
National City, CA 91950
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 157
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
(800) 898-2020 Accessibility: B; Members National City, CA 91950
Provider ID: 268800 should call the provider’s (619) 425-7755
License: A114976 office to discuss their Provider ID: 268366
Credentials and/or board accessibility needs when there License: A155296
certification: No is limited access or when Credentials and/or board
Accepting New Members: Yes accessibility indicators are not certification: No
Hours: M-SA 9AM-5PM present. Accepting New Members: Yes
PTA: No Hours: M-SA 9AM-5PM
Other Language: Gujarati, PTA: No
Hindi, Spanish, Tagalog, Prabhu, Sujata MD Other Language: Arabic,
Vietnamese 2240 E Plaza Blvd Ste F And G Spanish
Cultural Competency: NR National City, CA 91950 Cultural Competency: NR
Accessibility: B; Members (619) 470-2700 Accessibility: B; Members
should call the provider’s Provider ID: 268921 should call the provider’s
office to discuss their License: A115965 office to discuss their
accessibility needs when there Credentials and/or board accessibility needs when there
is limited access or when certification: No is limited access or when
accessibility indicators are not Accepting New Members: Yes accessibility indicators are not
present. Hours: M-SA 9AM-5PM present.
PTA: No
Other Language: Spanish,
Pons, Mauricio MD Tagalog, Telugu, Vietnamese Rajsbaum, Martin MD
1520 E Plaza Blvd Cultural Competency: NR 1520 E Plaza Blvd
National City, CA 91950 Accessibility: B; Members National City, CA 91950
(619) 425-7755 should call the provider’s (619) 425-7755
Provider ID: 268353 office to discuss their Provider ID: 268294
License: A87650 accessibility needs when there License: A42670
Credentials and/or board is limited access or when Credentials and/or board
certification: No accessibility indicators are not certification: No
Accepting New Members: Yes present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM Hours: M-SA 9AM-5PM
PTA: No PTA: No
Other Language: Spanish Peairs, James MD Other Language: Arabic,
Cultural Competency: NR 1520 E Plaza Blvd Russian, Spanish, Tagalog
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 158
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Cultural Competency: NR National City, CA 91950 Cultural Competency: NR
Accessibility: B; Members (619) 425-7755 Accessibility: B; Members
should call the provider’s Provider ID: 268285 should call the provider’s
office to discuss their License: A150205 office to discuss their
accessibility needs when there Credentials and/or board accessibility needs when there
is limited access or when certification: No is limited access or when
accessibility indicators are not Accepting New Members: Yes accessibility indicators are not
present. Hours: M-SA 9AM-5PM present.
PTA: No
Other Language: Arabic,
Rice, Lawrence MD Spanish, Tagalog Treger, Paul MD
655 Euclid Ave Ste 302 Cultural Competency: NR 655 Euclid Ave Ste 302
National City, CA 91950 Accessibility: B; Members National City, CA 91950
(619) 472-1010 should call the provider’s (619) 472-1010
Provider ID: 269039 office to discuss their Provider ID: 268812
License: C31021 accessibility needs when there License: G26803
Credentials and/or board is limited access or when Credentials and/or board
certification: No accessibility indicators are not certification: No
Accepting New Members: Yes present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM Hours: M-SA 9AM-5PM
PTA: No PTA: No
Other Language: Spanish Skaf, Ayham MD Cultural Competency: NR
Cultural Competency: NR 1520 E Plaza Blvd Accessibility: B; Members
Accessibility: B; Members National City, CA 91950 should call the provider’s
should call the provider’s (619) 425-7755 office to discuss their
office to discuss their Provider ID: 268279 accessibility needs when there
accessibility needs when there License: A120584 is limited access or when
is limited access or when Credentials and/or board accessibility indicators are not
accessibility indicators are not certification: No present.
present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No Wainess, Reid MD
Sassani, Patrick MD Other Language: Arabic, 2240 E Plaza Blvd Ste F & G
1520 E Plaza Blvd Spanish National City, CA 91950
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 159
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
(800) 898-2020 Cultural Competency: NR Lozier, Jeffrey MD
Provider ID: 254760
License: A108766
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Armenian,
Cantonese, Hebrew,
Mandarin, Spanish,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Wasserstrom, Jeffrey MD
655 Euclid Ave Ste 302
National City, CA 91950
(619) 472-1010
Provider ID: 129187
License: G54813
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Zabaneh, Alexander MD
655 Euclid Ave Ste 302
National City, CA 91950
(619) 472-1010
Provider ID: 269121
License: A154697
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3140
Provider ID: 270187
License: G54719
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92103
El Khatib, Nora MD
233 Lewis St
San Diego, CA 92103
(619) 501-9050
Provider ID: 269853
License: A140794
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 160
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Other Language: Arabic, Haak, Logan MD PTA: Yes
Spanish 4077 5th Ave Other Language: Spanish,
Cultural Competency: NR San Diego, CA 92103 Tagalog, Vietnamese
Accessibility: B; Members (619) 294-8111 Cultural Competency: NR
should call the provider’s Provider ID: 270058 Accessibility: B, W; Members
office to discuss their License: A110896 should call the provider’s
accessibility needs when there Credentials and/or board office to discuss their
is limited access or when certification: No accessibility needs when there
accessibility indicators are not Accepting New Members: Yes is limited access or when
present. Hours: M-SA 9AM-5PM accessibility indicators are not
PTA: No present.
Other Language: Farsi,
Gualtieri, Christopher MD Spanish 92111 3969 4th Ave Ste 300 Cultural Competency: NR
San Diego, CA 92103 Accessibility: B; Members Binder, Nicholas MD
(619) 688-2648 should call the provider’s 4344 Convoy St Ste C2
Provider ID: 252313 office to discuss their San Diego, CA 92111
License: G73020 accessibility needs when there (858) 565-8822
Credentials and/or board is limited access or when Provider ID: 268755
certification: Yes accessibility indicators are not License: A124698
Accepting New Members: Yes present. Credentials and/or board
Hours: M-SA 9AM-5PM certification: No
PTA: Yes 92105 Accepting New Members: Yes
Other Language: Spanish Hours: M-SA 9AM-5PM
Cultural Competency: NR Huynh, Paul MD PTA: No
Accessibility: B, W; Members 4844 University Ave Ste A Cultural Competency: NR
should call the provider’s San Diego, CA 92105 Accessibility: B; Members
office to discuss their (619) 283-1303 should call the provider’s
accessibility needs when there Provider ID: 245200 office to discuss their
is limited access or when License: A79141 accessibility needs when there
accessibility indicators are not Credentials and/or board is limited access or when
present. certification: No accessibility indicators are not
Accepting New Members: Yes present.
Hours: M-SA 9AM-5PM
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 161
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Chang, Tom MD
4344 Convoy St Ste C2
San Diego, CA 92111
(858) 565-8822
Provider ID: 270361
License: A69909
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Armenian, Cantonese,
Croatian, Korean, Mandarin,
Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Special Expertise: Deafness or
Hard-of-Hearing, Co-occuring
Disorders
Mcgraw, Joseph MD
4344 Convoy St Ste C2
San Diego, CA 92111
(800) 898-2020
Provider ID: 269704
License: A155228
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Miller, Douglas MD
4344 Convoy St Ste C2
San Diego, CA 92111
(858) 565-8822
Provider ID: 99220
License: G52627
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Patel, Gitane MD
4344 Convoy St Ste C2
San Diego, CA 92111
(800) 898-2020
Provider ID: 268743
License: A108603
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Gujarati, Spanish, Tagalog,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Patel, Sarjan MD
4344 Convoy St Ste C2
San Diego, CA 92111
(800) 898-2020
Provider ID: 268801
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 162
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
License: A114976
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Gujarati,
Hindi, Spanish, Tagalog,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Prabhu, Sujata MD
4344 Convoy St Ste C2
San Diego, CA 92111
(800) 898-2020
Provider ID: 268919
License: A115965
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog, Telugu, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Wainess, Reid MD
4344 Convoy St Ste C2
San Diego, CA 92111
(800) 898-2020
Provider ID: 254762
License: A108766
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Armenian,
Cantonese, Hebrew,
Mandarin, Spanish,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92115
Binder, Nicholas MD
6945 El Cajon Blvd
San Diego, CA 92115
(619) 697-4600
Provider ID: 268751
License: A124698
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Katzman, Barry MD
6945 El Cajon Blvd
San Diego, CA 92115
(800) 898-2020
Provider ID: 247366
License: A34834
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish,
Tagalog, Vietnamese
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 163
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Cultural Competency: NR (619) 697-4600 Other Language: Armenian,
Accessibility: B; Members Provider ID: 99211 Cantonese, Indonesian,
should call the provider’s License: G52627 Mandarin, Spanish, Tagalog,
office to discuss their Credentials and/or board Vietnamese
accessibility needs when there certification: No Cultural Competency: NR
is limited access or when Accepting New Members: Yes Accessibility: B; Members
accessibility indicators are not Hours: M-SA 9AM-5PM should call the provider’s
present. PTA: No office to discuss their
Other Language: Spanish, accessibility needs when there
Tagalog, Vietnamese is limited access or when
Mcgraw, Joseph MD Cultural Competency: NR accessibility indicators are not
6945 El Cajon Blvd Accessibility: B; Members present.
San Diego, CA 92115 should call the provider’s
(619) 697-4600 office to discuss their
Provider ID: 269702 accessibility needs when there Patel, Gitane MD
License: A155228 is limited access or when 6945 El Cajon Blvd
Credentials and/or board accessibility indicators are not San Diego, CA 92115
certification: No present. (619) 697-4600
Accepting New Members: Yes Provider ID: 268738
Hours: M-SA 9AM-5PM License: A108603
PTA: No Morrison-reyes, Joshua MD Credentials and/or board
Cultural Competency: NR 6945 El Cajon Blvd certification: No
Accessibility: B; Members San Diego, CA 92115 Accepting New Members: Yes
should call the provider’s (619) 697-4600 Hours: M-SA 9AM-5PM
office to discuss their Provider ID: 269178 PTA: Yes
accessibility needs when there License: A125435 Other Language: Arabic,
is limited access or when Credentials and/or board Gujarati, Spanish, Tagalog,
accessibility indicators are not certification: No Vietnamese
present. Accepting New Members: Yes Cultural Competency: NR
Hours: M-SA 9AM-5PM Accessibility: B; Members
PTA: No should call the provider’s
Miller, Douglas MD office to discuss their
6945 El Cajon Blvd accessibility needs when there
San Diego, CA 92115 is limited access or when
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 164
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
accessibility indicators are not Credentials and/or board is limited access or when
present. certification: Yes accessibility indicators are not
Accepting New Members: Yes present.
Hours: M-SA 9AM-5PM
Patel, Sarjan MD PTA: No 92126 6945 El Cajon Blvd Other Language: Spanish,
San Diego, CA 92115 Tagalog, Telugu, Vietnamese Huynh, Paul MD
(619) 697-4600 Cultural Competency: NR 10737 Camino Ruiz Ste 100
Provider ID: 268798 Accessibility: B; Members San Diego, CA 92126
License: A114976 should call the provider’s (858) 549-3200
Credentials and/or board office to discuss their Provider ID: 245199
certification: Yes accessibility needs when there License: A79141
Accepting New Members: Yes is limited access or when Credentials and/or board
Hours: M-SA 9AM-5PM accessibility indicators are not certification: Yes
PTA: Yes present. Accepting New Members: Yes
Other Language: Gujarati, Hours: M-SA 9AM-5PM
Hindi, Spanish, Tagalog, PTA: Yes
Vietnamese Zabaneh, Alexander MD Other Language: Spanish,
Cultural Competency: NR 6945 El Cajon Blvd Tagalog, Vietnamese
Accessibility: B, W; Members San Diego, CA 92115 Cultural Competency: NR
should call the provider’s (619) 697-4600 Accessibility: B, W; Members
office to discuss their Provider ID: 269122 should call the provider’s
accessibility needs when there License: A154697 office to discuss their
is limited access or when Credentials and/or board accessibility needs when there
accessibility indicators are not certification: No is limited access or when
present. Accepting New Members: Yes accessibility indicators are not
Hours: M-SA 9AM-5PM present.
PTA: No
Prabhu, Sujata MD Other Language: Arabic
6945 El Cajon Blvd Cultural Competency: NR Ng, Diana MD
San Diego, CA 92115 Accessibility: B; Members 10737 Camino Ruiz Ste 100
(800) 898-2020 should call the provider’s San Diego, CA 92126
Provider ID: 268916 office to discuss their (858) 549-3200
License: A115965 accessibility needs when there Provider ID: 270011
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 165
126
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
License: A115695
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Chinese,
Yue Chinese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN MARCOS
92069
Prestera, Tory MD
100 N Rancho Santa Fe Rd Ste
San Marcos, CA 92069
(760) 598-0400
Provider ID: 204707
License: A62321
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish,
Thai
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Optometrist
ALPINE
91901
Aoto, Kim OD
1620 Alpine Blvd Ste 117
Alpine, CA 91901
(800) 898-2020
Provider ID: 268720
License: OPT14524
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dyer, Sharon OD
1620 Alpine Blvd Ste 117
Alpine, CA 91901
(619) 445-2687
Provider ID: 268868
License: OPT33450
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Soriano, Catherine OD
1620 Alpine Blvd Ste 117
Alpine, CA 91901
(800) 898-2020
Provider ID: 268727
License: OPT13109
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 166
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
PTA: No
Other Language: Spanish,
Tagalog, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CHULA VISTA
91910
Bakriwala, Ketan OD
342 F St
Chula Vista, CA 91910
(619) 422-1471
Provider ID: 268773
License: OPT14277
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Gujarati,
Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Biaggi, Michelle OD
342 F St
Chula Vista, CA 91910
(619) 422-1471
Provider ID: 265528
License: OPT33462
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mascareno, Efrain OD
440 4th Ave # 9
Chula Vista, CA 91910
(619) 427-2020
Provider ID: 268680
License: OPT10906
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Nguyen, Thu OD
342 F St
Chula Vista, CA 91910
(619) 422-1471
Provider ID: 265518
License: OPT14274
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 167
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
91911
El-moghrabi, Roula OD
835 3rd Ave Ste A
Chula Vista, CA 91911
(619) 425-7755
Provider ID: 245689
License: OPT34126
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
French, Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
El-moghrabi, Nancy OD
835 3rd Ave Ste A
Chula Vista, CA 91911
(619) 425-7755
Provider ID: 258049
License: OPT34125
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
91915
Mascareno, Efrain OD
2260 Otay Lakes Rd Ste 111
Chula Vista, CA 91915
(619) 421-5550
Provider ID: 268679
License: OPT10906
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
EL CAJON
92020
Aoto, Kim OD
450 Fletcher Pkwy Ste 112
El Cajon, CA 92020
(800) 898-2020
Provider ID: 268721
License: OPT14524
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dyer, Sharon OD
450 Fletcher Pkwy Ste 112
El Cajon, CA 92020
(619) 440-5400
Provider ID: 268869
License: OPT33450
Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 168
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Soriano, Catherine OD
450 Fletcher Pkwy Ste 112
El Cajon, CA 92020
(800) 898-2020
Provider ID: 268729
License: OPT13109
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Aoto, Kim OD
830 W Valley Pkwy Ste 300
Escondido, CA 92025
(619) 463-0331
Provider ID: 268719
License: OPT14524
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dyer, Sharon OD
830 W Valley Pkwy Ste 300
Escondido, CA 92025
(760) 743-5872
Provider ID: 268870
License: OPT33450
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Soriano, Catherine OD
830 W Valley Pkwy Ste 300
Escondido, CA 92025
(800) 898-2020
Provider ID: 268730
License: OPT13109
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 169
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
accessibility indicators are not
present.
LA JOLLA
92037
Moshtaghi, Mehri OD
9850 Genesee Ave Ste 310
La Jolla, CA 92037
(800) 898-2020
Provider ID: 279262
License: OPT13972
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92093
Hoo, Pamela OD
9415 Campus Point Dr
La Jolla, CA 92093
(858) 534-6290
Provider ID: 269621
License: OPT11033
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mcclean, Esmeralda OD
9415 Campus Point Dr
La Jolla, CA 92093
(858) 534-6290
Provider ID: 269907
License: OPT15001
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Dyer, Sharon OD
5565 Grossmont Center Dr Ste
551
La Mesa, CA 91942
(800) 898-2020
Provider ID: 268873
License: OPT33450
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
El-moghrabi, Roula OD
8851 Center Dr Ste 406
La Mesa, CA 91942
(619) 425-7755
Provider ID: 245697
License: OPT34126
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 170
3
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
French, Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Soriano, Catherine OD
5565 Grossmont Center Dr Ste
La Mesa, CA 91942
(800) 898-2020
Provider ID: 268732
License: OPT13109
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Aoto, Kim OD
2240 E Plaza Blvd Ste F-g
National City, CA 91950
(800) 898-2020
Provider ID: 268722
License: OPT14524
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dyer, Sharon OD
2240 E Plaza Blvd Ste F And G
National City, CA 91950
(800) 898-2020
Provider ID: 268872
License: OPT33450
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
El-moghrabi, Roula OD
2835 Highland Ave Ste B
National City, CA 91950
(844) 200-2426
Provider ID: 245696
License: OPT34126
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
French, Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 171
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
El-moghrabi, Roula OD
1520 E Plaza Blvd
National City, CA 91950
(619) 425-7755
Provider ID: 268284
License: OPT34126
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
French, Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
El-moghrabi, Nancy OD
1520 E Plaza Blvd
National City, CA 91950
(619) 425-7755
Provider ID: 268380
License: OPT34125
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Soriano, Catherine OD
2240 E Plaza Blvd Ste F And G
National City, CA 91950
(800) 898-2020
Provider ID: 268728
License: OPT13109
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Soriano, Catherine OD
655 Euclid Ave Ste 302
National City, CA 91950
(800) 898-2020
Provider ID: 268731
License: OPT13109
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
OCEANSIDE
92056
Ring, Robert OD
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 172
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
3998 Vista Way Ste 204
Oceanside, CA 92056
(760) 726-9383
Provider ID: 269380
License: OPT6781
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Kim, Michelle OD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3141
Provider ID: 270014
License: OPT11566
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92111
Aoto, Kim OD
4344 Convoy St Ste C2
San Diego, CA 92111
(619) 463-0331
Provider ID: 268718
License: OPT14524
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dyer, Sharon OD
4344 Convoy St Ste C2
San Diego, CA 92111
(800) 898-3788
Provider ID: 268871
License: OPT33450
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92115
Aoto, Kim OD
6945 El Cajon Blvd
San Diego, CA 92115
(800) 898-2020
Provider ID: 268723
License: OPT14524
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 173
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
PTA: No Soriano, Catherine OD PTA: No
Other Language: Spanish, 6945 El Cajon Blvd Other Language: Arabic,
Vietnamese San Diego, CA 92115 French, Spanish, Tagalog
Cultural Competency: NR (619) 697-4600 Cultural Competency: NR
Accessibility: B; Members Provider ID: 268726 Accessibility: B; Members
should call the provider’s License: OPT13109 should call the provider’s
office to discuss their Credentials and/or board office to discuss their
accessibility needs when there certification: No accessibility needs when there
is limited access or when Accepting New Members: Yes is limited access or when
accessibility indicators are not Hours: M-SA 9AM-5PM accessibility indicators are not
present. PTA: Yes present.
Other Language: Spanish,
Tagalog, Vietnamese 92129 Dyer, Sharon OD Cultural Competency: NR
6945 El Cajon Blvd Accessibility: B; Members El-moghrabi, Roula OD
San Diego, CA 92115 should call the provider’s 9995 Carmel Mountain Rd Ste
(619) 697-4600 office to discuss their B10-11
Provider ID: 268867 accessibility needs when there San Diego, CA 92129
License: OPT33450 is limited access or when (844) 200-2426
Credentials and/or board accessibility indicators are not Provider ID: 245692
certification: No present. License: OPT34126
Accepting New Members: Yes Credentials and/or board
Hours: M-SA 9AM-5PM 92126 certification: No
PTA: No Accepting New Members: Yes
Cultural Competency: NR El-moghrabi, Roula OD Hours: M-SA 9AM-5PM
Accessibility: B; Members 10737 Camino Ruiz Ste 138 PTA: No
should call the provider’s San Diego, CA 92126 Other Language: Arabic,
office to discuss their (844) 200-2426 French, Spanish, Tagalog
accessibility needs when there Provider ID: 245695 Cultural Competency: NR
is limited access or when License: OPT34126 Accessibility: B; Members
accessibility indicators are not Credentials and/or board should call the provider’s
present. certification: No office to discuss their
Accepting New Members: Yes accessibility needs when there
Hours: M-SA 9AM-5PM is limited access or when
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 174
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
accessibility indicators are not
present.
92131
El-moghrabi, Roula OD
9855 Erma Rd Ste 105
San Diego, CA 92131
(844) 200-2426
Provider ID: 245694
License: OPT34126
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
French, Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
VISTA
92083
Gee, Jennifer OD
134 Grapevine Rd
Vista, CA 92083
(760) 631-5000
Provider ID: 273114
License: OPT14671
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Kim, Michael OD
134 Grapevine Rd
Vista, CA 92083
(760) 631-5000
Provider ID: 245239
License: OPT12174
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Tran, Thuy-diem OD
134 Grapevine Rd
Vista, CA 92083
(760) 631-5000
Provider ID: 245677
License: OPT14292
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92084
Gee, Jennifer OD
1000 Vale Terrace Dr
Vista, CA 92084
(760) 631-5000
Provider ID: 273113
License: OPT14671
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 175
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mora, Wendy OD
1000 Vale Terrace Dr
Vista, CA 92084
(760) 631-5000
Provider ID: 242634
License: OPT15016
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rich, Ryan OD
1000 Vale Terrace Dr
Vista, CA 92084
(760) 631-5000
Provider ID: 242998
License: OPT15053
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Tam, Emily OD
1000 Vale Terrace Dr
Vista, CA 92084
(760) 631-5000
Provider ID: 277978
License: OPT15147
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Tran, Thuy-diem OD
1000 Vale Terrace Dr
Vista, CA 92084
(760) 631-5000
Provider ID: 245676
License: OPT14292
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 176
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Otolaryngology
CARLSBAD
92008
Donaldson, Chadwick MD
2390 Faraday Ave
Carlsbad, CA 92008
(858) 909-0770
Provider ID: 268146
License: A84567
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Riedler, Kiersten MD
2390 Faraday Ave
Carlsbad, CA 92008
(858) 909-0770
Provider ID: 256202
License: A135480
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CHULA VISTA
91910
Jansen, Cornelius MD
577 Third Ave
Chula Vista, CA 91910
(619) 426-5181
Provider ID: 255731
License: G85048
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
91911
Patsias, Alexis MD
765 Medical Center Ct Ste 210
Chula Vista, CA 91911
(619) 482-0565
Provider ID: 268806
License: A160436
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92029
Fitzgerald, Patrick MD
1955 Citracado Pkwy Ste 200
Escondido, CA 92029
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 177
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
(858) 485-7870
Provider ID: 269266
License: G80210
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Chang, Angela MD
9834 Genesee Ave Ste 111
La Jolla, CA 92037
(858) 909-0770
Provider ID: 269308
License: A100380
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Chinese,
Mandarin, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Calzada, Audrey MD
9834 Genesee Ave Ste 111
La Jolla, CA 92037
(858) 909-0770
Provider ID: 269278
License: A107965
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Busino, Rowley MD
5565 Grossmont Center Dr Ste
101
La Mesa, CA 91942
(619) 464-3353
Provider ID: 53306
License: A112508
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic,
French, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Driskill, Brent MD
5565 Grossmont Center Dr Ste
101
La Mesa, CA 91942
(619) 464-3353
Provider ID: 121484
License: C146197
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 178
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
PTA: No Accepting New Members: Yes
Cultural Competency: NR Moles, Jeremiah MD Hours: M-SA 9AM-5PM
Accessibility: B; Members 5565 Grossmont Center Dr Ste PTA: No
should call the provider’s 101 Bldg 3 Other Language: Spanish
office to discuss their La Mesa, CA 91942 Cultural Competency: NR
accessibility needs when there (619) 464-3353 Accessibility: B; Members
is limited access or when Provider ID: 46814 should call the provider’s
accessibility indicators are not License: A112009 office to discuss their
present. Credentials and/or board accessibility needs when there
certification: Yes is limited access or when
Accepting New Members: Yes accessibility indicators are not
Mccallion, Patrick MD Hours: M-SA 9AM-5PM present.
5565 Grossmont Center Dr Ste PTA: No
101 Bldg 3 Other Language: Arabic,
La Mesa, CA 91942 Farsi, Spanish, Tongan Paul, Supriti MD
(619) 464-3353 Cultural Competency: NR 5565 Grossmont Center Dr Ste
Provider ID: 26600 Accessibility: B; Members 101 Bldg 3
License: G64989 should call the provider’s La Mesa, CA 91942
Credentials and/or board office to discuss their (619) 464-3353
certification: Yes accessibility needs when there Provider ID: 91838
Accepting New Members: Yes is limited access or when License: A120434
Hours: M-SA 9AM-5PM accessibility indicators are not Credentials and/or board
PTA: No present. certification: No
Other Language: Arabic, Accepting New Members: Yes
Spanish Hours: M-SA 9AM-5PM
Cultural Competency: NR Patsias, Alexis MD PTA: No
Accessibility: B; Members 5565 Grossmont Center Dr Ste Other Language: Arabic,
should call the provider’s 101 Hebrew, Spanish
office to discuss their La Mesa, CA 91942 Cultural Competency: NR
accessibility needs when there (619) 464-3353 Accessibility: B; Members
is limited access or when Provider ID: 243551 should call the provider’s
accessibility indicators are not License: A160436 office to discuss their
present. Credentials and/or board accessibility needs when there
certification: No is limited access or when
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 179
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
accessibility indicators are not
present.
Pitzer, Geoffrey MD
5565 Grossmont Center Dr Ste
101 Bldg 3
La Mesa, CA 91942
(619) 464-3353
Provider ID: 103378
License: A125888
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Farsi, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rensink, Michael MD
5565 Grossmont Center Dr Ste
101 Bldg 3
La Mesa, CA 91942
(619) 464-3353
Provider ID: 269082
License: G20200
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Schalch Lepe, Paul MD
5565 Grossmont Center Dr
La Mesa, CA 91942
(619) 464-3353
Provider ID: 122525
License: A92839
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
German, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Schalch Lepe, Paul MD
5565 Grossmont Center Dr Ste
101
La Mesa, CA 91942
(619) 464-3353
Provider ID: 269980
License: A92839
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
German, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Skelton, Sean DO
5565 Grossmont Center Dr Ste
101 Bldg 3
La Mesa, CA 91942
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 180
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
(619) 464-3353
Provider ID: 269028
License: 20A7852
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Japanese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Fitzgerald, Patrick MD
15525 Pomerado Rd Ste C1
Poway, CA 92064
(858) 485-7870
Provider ID: 70742
License: G80210
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Learn, Alison MD
15525 Pomerado Rd Ste C1
Poway, CA 92064
(858) 485-7870
Provider ID: 70715
License: G78450
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92121
Riedler, Kiersten MD
5405 Oberlin Dr
San Diego, CA 92121
(858) 909-0770
Provider ID: 256203
License: A135480
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Pediatrics
CHULA VISTA
91911
Tiznado, Ernesto Garcia MD
1635 3rd Ave Ste L
Chula Vista, CA 91911
(619) 425-8901
Provider ID: 269717
License: A45183
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 181
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Longhurst, Christopher MD
9300 Campus Point Dr
La Jolla, CA 92037
(858) 657-7000
Provider ID: 269432
License: A80051
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Adigopula, Bina MD
6942 University Ave Ste A
La Mesa, CA 91942
(619) 698-2184
Provider ID: 218149
License: A45273
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Hindi,
Spanish, Telugu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Bailony, Mohammed MD
655 Euclid Ave Ste 205
National City, CA 91950
(619) 470-1945
Provider ID: 274980
License: A34406
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92126
Karmakar, Kanka MD
10737 Camino Ruiz Ste 235
San Diego, CA 92126
(844) 200-2426
Provider ID: 213847
License: C54941
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Bengali,
Hindi, Polish, Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 182
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Physical Medicine /
Rehabilitation
ALPINE
91901
Lao, Jesus MD
1392 Tavern Rd
Alpine, CA 91901
(619) 722-4270
Provider ID: 268762
License: A72729
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Chinese,
Mandarin, Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CARLSBAD
92011
Jaffer, Jihad MD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 119557
License: A98822
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Madhav, Sandip MD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 256381
License: A128918
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Gujarati
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CHULA VISTA
91910
Bullock, Andrew DO
344 F St Ste 100
Chula Vista, CA 91910
(619) 379-6579
Provider ID: 268443
License: 20A6842
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Fataleka, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 183
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Kasendorf, Roger DO
9834 Genesee Ave Ste 221
La Jolla, CA 92037
(858) 558-1275
Provider ID: 209021
License: 20A12928
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Bullock, Andrew DO
15644 Pomerado Rd Ste 204
Poway, CA 92064
(619) 379-6579
Provider ID: 268442
License: 20A6842
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Farsi,
Fataleka, Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92108
Thompson, Sharron MD
3703 Camino Del Rio S Ste 210
San Diego, CA 92108
(619) 640-5555
Provider ID: 278396
License: G55454
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92120
Scott, Robert MD
6719 Alvarado Rd Ste 200
San Diego, CA 92120
(619) 229-3932
Provider ID: 119955
License: G73573
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Physicians Assistant
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 184
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
CARLSBAD
92011
Burney, Melissa PA
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 277535
License: PA58612
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Heinen, John PA
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 241051
License: PA10565
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hermanson, Kathleen PA
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 269004
License: PA51880
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Inocelda, Andrew PA
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 269089
License: PA19207
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CHULA VISTA
91910
Alicea, Raul PA
450 Fourth Ave Ste 215
Chula Vista, CA 91910
(619) 434-0204
Provider ID: 268631
License: PA54627
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 185
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
should call the provider’s License: PA54404 accessibility needs when there
office to discuss their Credentials and/or board is limited access or when
accessibility needs when there certification: No accessibility indicators are not
is limited access or when Accepting New Members: Yes present.
accessibility indicators are not Hours: M-SA 9AM-5PM
present. PTA: No 91911 Other Language: Arabic,
Russian, Spanish Macasadia, Marites PA
Holm, Tyler PA Cultural Competency: NR 752 Medical Center Ct Ste 210
480 Fourth Ave Ste 501 Accessibility: B; Members Chula Vista, CA 91911
Chula Vista, CA 91910 should call the provider’s (619) 656-0206
(619) 425-9510 office to discuss their Provider ID: 268788
Provider ID: 241021 accessibility needs when there License: PA15254
License: PA55864 is limited access or when Credentials and/or board
Credentials and/or board accessibility indicators are not certification: No
certification: No present. Accepting New Members: Yes
Accepting New Members: Yes Hours: M-SA 9AM-5PM
Hours: M-SA 9AM-5PM PTA: No
PTA: No Silver, Nikki PA Cultural Competency: NR
Cultural Competency: NR 480 Fourth Ave Ste 501 Accessibility: B; Members
Accessibility: B; Members Chula Vista, CA 91910 should call the provider’s
should call the provider’s (619) 425-9510 office to discuss their
office to discuss their Provider ID: 242650 accessibility needs when there
accessibility needs when there License: PA55325 is limited access or when
is limited access or when Credentials and/or board accessibility indicators are not
accessibility indicators are not certification: No present.
present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM 91914 PTA: No
La Berge-inda, Priscilla PA Other Language: Spanish Solai, Radha PA
450 Fourth Ave Ste 215 Cultural Competency: NR 890 Eastlake Pkwy Ste 205
Chula Vista, CA 91910 Accessibility: B; Members Chula Vista, CA 91914
(619) 434-0204 should call the provider’s (619) 482-0300
Provider ID: 265072 office to discuss their Provider ID: 247295
License: PA54899
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 186
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Vargas, Christopher PA
2452 Fenton St Ste C203
Chula Vista, CA 91914
(619) 600-5309
Provider ID: 268744
License: PA55263
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
EL CAJON
92020
La Berge-inda, Priscilla PA
328 Highland Ave # 200
El Cajon, CA 92020
(619) 930-9404
Provider ID: 265073
License: PA54404
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Russian, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ENCINITAS
92024
Blasic, Vanessa PA
320 Santa Fe Dr Ste 108
Encinitas, CA 92024
(760) 436-4558
Provider ID: 269274
License: PA54781
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dougherty, Clara PA
320 Santa Fe Dr Ste 108
Encinitas, CA 92024
(760) 436-4558
Provider ID: 269171
License: PA17439
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 187
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Norman, Stacy PA
477 N El Camino Real Ste D308
Encinitas, CA 92024
(760) 436-2300
Provider ID: 243430
License: PA17505
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Vanetsky, Gary PA
477 N El Camino Real Ste D308
Encinitas, CA 92024
(760) 436-2300
Provider ID: 269152
License: PA15456
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Ross, Anne PA
425 N Date St
Escondido, CA 92025
(760) 737-2035
Provider ID: 269221
License: PA53359
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92029
Chatfield, Alexandra PA
1955 Citracado Pkwy Ste 200
Escondido, CA 92029
(760) 743-4789
Provider ID: 276716
License: PA57107
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Flores, Ariane-jane PA
1955 Citracado Pkwy Ste 302
Escondido, CA 92029
(760) 743-5111
Provider ID: 241659
License: PA56330
Credentials and/or board
certification: No
Accepting New Members: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 188
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Inocelda, Andrew PA
1955 Citracado Pkwy Ste 102
Escondido, CA 92029
(760) 631-3000
Provider ID: 269090
License: PA19207
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
FALLBROOK
92028
Sering, Malia PA
1309 S Mission Rd Ste A
Fallbrook, CA 92028
(760) 728-7546
Provider ID: 269279
License: PA19459
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Blasic, Vanessa PA
9850 Genesee Ave Ste 440
La Jolla, CA 92037
(858) 453-5944
Provider ID: 269273
License: PA54781
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dougherty, Clara PA
9850 Genesee Ave Ste 440
La Jolla, CA 92037
(858) 453-9944
Provider ID: 269170
License: PA17439
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 189
112
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
91942
Barker, Scott PA
5565 Grossmont Center Dr Ste
La Mesa, CA 91942
(619) 465-0083
Provider ID: 269071
License: PA22121
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Elo, Kristin PA
5555 Grossmont Center Dr
La Mesa, CA 91942
(619) 644-3030
Provider ID: 241862
License: PA19305
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Holm, Tyler PA
8851 Center Dr Ste 601
La Mesa, CA 91942
(619) 441-9811
Provider ID: 241022
License: PA55864
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Keyes, Amy PA
5565 Grossmont Center Dr Ste
101
La Mesa, CA 91942
(619) 464-3353
Provider ID: 247011
License: PA56805
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Raymond, Alain PA
8851 Center Dr Ste 505
La Mesa, CA 91942
(619) 461-3880
Provider ID: 269057
License: PA21466
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French
Cultural Competency: NR
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 190
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sacknoff, Stefanie PA
5555 Grossmont Center Dr
La Mesa, CA 91942
(619) 644-3030
Provider ID: 268946
License: PA51280
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Suna Sitto, Moheen PA
7051 Alvarado Rd Ste 101
La Mesa, CA 91942
(619) 625-1144
Provider ID: 269776
License: PA22855
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Wray, Amy PA
5555 Grossmont Center Dr
La Mesa, CA 91942
(619) 644-3030
Provider ID: 268840
License: PA17578
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Macasadia, Marites PA
610 Euclid Ave Ste 302
National City, CA 91950
(619) 527-7700
Provider ID: 268787
License: PA15254
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Chatfield, Alexandra PA
15611 Pomerado Rd Ste 525
Poway, CA 92064
(858) 485-0050
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 191
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Provider ID: 276715
License: PA57107
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Grindle, Silvia PA
13525 Midland Rd Ste F
Poway, CA 92064
(858) 486-9100
Provider ID: 269926
License: PA21499
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Huang, Stephanie PA
15611 Pomerado Rd Ste 505
Poway, CA 92064
(760) 631-3000
Provider ID: 268025
License: PA21008
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Huang, Stephanie PA
15721 Pomerado Rd
Poway, CA 92064
(760) 631-3000
Provider ID: 269352
License: PA21008
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92103
Beale, Evan PA
4060 4th Ave Ste 415
San Diego, CA 92103
(619) 298-9809
Provider ID: 271081
License: PA55344
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 192
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Nelms, Michael PA
4060 4th Ave Ste 415
San Diego, CA 92103
(619) 298-9809
Provider ID: 242771
License: PA14379
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92111
Ceriale, Christopher PA
7526 Clairemont Mesa Blvd
San Diego, CA 92111
(888) 743-7526
Provider ID: 269867
License: PA54651
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rai, Georgina PA
7526 Clairemont Mesa Blvd
San Diego, CA 92111
(858) 743-7526
Provider ID: 270053
License: PA54629
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92121
Beale, Evan PA
9339 Genesee Ave Ste 350
San Diego, CA 92121
(858) 454-4300
Provider ID: 271080
License: PA55344
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Holm, Tyler PA
9333 Genesee Ave Ste 350 A
San Diego, CA 92121
(858) 455-6460
Provider ID: 241020
License: PA55864
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 193
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Longobardo, Francesca PA
9333 Genesee Ave Ste 350a
San Diego, CA 92121
(858) 455-6460
Provider ID: 241372
License: PA52844
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Silver, Nikki PA
9333 Genesee Ave Ste 350
San Diego, CA 92121
(858) 455-6460
Provider ID: 242649
License: PA55325
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92123
Daneshvar, Abraham PA
9610 Granite Ridge Dr Ste B
San Diego, CA 92123
(858) 558-8150
Provider ID: 271004
License: PA52905
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Turkish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Negley, Joelle PA
9610 Granite Ridge Dr Ste B
San Diego, CA 92123
(619) 461-3880
Provider ID: 269821
License: PA52553
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN MARCOS
92069
Sering, Malia PA
838 Nordahl Rd Ste 250
San Marcos, CA 92069
(760) 738-7600
Provider ID: 269280
License: PA19459
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 194
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SANTEE
92071
Cool, Jay PA
120 Town Center Pkwy
Santee, CA 92071
(619) 445-6200
Provider ID: 241374
License: PA53135
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
VISTA
92084
Wallace, Stephanie PA
1000 Vale Terrace Dr
Vista, CA 92084
(760) 631-5000
Provider ID: 239770
License: PA19629
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Podiatrist
CHULA VISTA
91910
Chisholm, John DPM
345 F St Ste 100
Chula Vista, CA 91910
(619) 427-3481
Provider ID: 268440
License: DPM3431
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Russian,
Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Canaba, Yvette MD
345 F St Ste 100
Chula Vista, CA 91910
(619) 427-3481
Provider ID: 268469
License: DPM5496
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 195
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Davidson, John DPM
345 F St Ste 100
Chula Vista, CA 91910
(619) 427-3481
Provider ID: 129545
License: DPM5418
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Puccinelli, Alayna DPM
345 F St Ste 100
Chula Vista, CA 91910
(619) 427-3481
Provider ID: 268461
License: DPM5349
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Russian,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Xu, Dixon DPM
345 F St Ste 100
Chula Vista, CA 91910
(619) 427-3481
Provider ID: 277917
License: DPM5596
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Mandarin,
Shanghaiese, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
EL CAJON
92019
Vallone, Melchior DPM
5442 Sycuan Rd
El Cajon, CA 92019
(619) 445-0707
Provider ID: 204673
License: DPM2201
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92020
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 196
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Farmer, Steven DPM
855 E Madison Ave
El Cajon, CA 92020
(619) 440-2751
Provider ID: 268976
License: DPM2895
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Farmer, Steven DPM
728 E Valley Pkwy
Escondido, CA 92025
(760) 737-6900
Provider ID: 268975
License: DPM2895
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Negron, Ricardo DPM
1001 E Grand Ave
Escondido, CA 92025
(858) 218-3000
Provider ID: 274646
License: DPM5260
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91941
Vallone, Melchior DPM
5129 Garfield St
La Mesa, CA 91941
(619) 465-3200
Provider ID: 26555
License: DPM2201
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Ahmed, Aisha DPM
1428 Highland Ave
National City, CA 91950
(844) 200-2426
Provider ID: 243131
License: DPM5369
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 197
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Other Language: Hindi,
Spanish, Urdu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Atmar, Akmal DPM
2345 E 8th St Ste 105
National City, CA 91950
(929) 287-4511
Provider ID: 269784
License: DPM5295
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Persian, Urdu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Chisholm, John DPM
610 Euclid Ave Ste 301
National City, CA 91950
(619) 292-2493
Provider ID: 268441
License: DPM3431
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Russian,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Davidson, John DPM
610 Euclid Ave Ste 301
National City, CA 91950
(619) 292-2493
Provider ID: 129542
License: DPM5418
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92104
Forg, Patricia DPM
3989 32nd St
San Diego, CA 92104
(619) 283-2097
Provider ID: 270062
License: DPM3775
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 198
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
certification: No accessibility needs when there
Accepting New Members: Yes is limited access or when92115 Hours: M-SA 9AM-5PM accessibility indicators are not
Foygelman, Aleksandr DPM PTA: No present.
4440 Euclid Ave Cultural Competency: NR
San Diego, CA 92115 Accessibility: B; Members
(619) 281-3338 should call the provider’s
Provider ID: 270221 office to discuss their
License: DPM4387 accessibility needs when there
CARLSBAD
92011
Alasantro, Lori PhDCredentials and/or board is limited access or when 6010 Hidden Valley Rd Ste 200certification: No accessibility indicators are not Carlsbad, CA 92011Accepting New Members: Yes present. (760) 631-3000Hours: M-SA 9AM-5PM
Psychologist
ALPINE
91901
Provider ID: 269067PTA: No License: PSY25817Other Language: Armenian, Credentials and/or boardBulgarian, Hebrew, Russian, certification: NoSpanish, Ukrainian Accepting New Members: YesCultural Competency: NR Hours: M-SA 9AM-5PMAccessibility: B; Members
Barmak, Shant PSYD PTA: Noshould call the provider’s 1620 Alpine Blvd Cultural Competency: NRoffice to discuss their Alpine, CA 91901 Accessibility: B; Members accessibility needs when there (619) 445-6200 should call the provider’sis limited access or when Provider ID: 129026 office to discuss theiraccessibility indicators are not License: PSY24998 accessibility needs when therepresent. Credentials and/or board is limited access or when
certification: No accessibility indicators are not92121
Accepting New Members: Yes present.
Hours: M-SA 9AM-5PMCollins, Michael DPM PTA: No9333 Genesee Ave Ste 350a Other Language: Armenian Rosen, Jay PhDSan Diego, CA 92121 Cultural Competency: NR 6010 Hidden Valley Rd Ste 200(858) 455-6460 Accessibility: B; Members Carlsbad, CA 92011Provider ID: 269866 should call the provider’s (760) 631-3000License: DPM5146 office to discuss their Provider ID: 269010Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 199
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
License: PSY25093
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Kaup, Allison PhD
15721 Pomerado Rd
Poway, CA 92064
(760) 631-3000
Provider ID: 269382
License: PSY26484
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rosen, Jay PhD
15721 Pomerado Rd
Poway, CA 92064
(760) 631-3000
Provider ID: 269011
License: PSY25093
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Pulmonary Diseases
CARLSBAD
92011
Hsing, Andrew MD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 125301
License: A127271
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CHULA VISTA
91914
Lira, Jose MD
841 Kuhn Dr Ste 200
Chula Vista, CA 91914
(619) 482-7301
Provider ID: 268769
License: A33913
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 200
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Lozano, Martha MD
841 Kuhn Dr Ste 200
Chula Vista, CA 91914
(619) 363-4000
Provider ID: 269322
License: A48551
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Bender, Frank MD
488 E Valley Pkwy Ste 211
Escondido, CA 92025
(760) 489-1458
Provider ID: 53988
License: G33933
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Popper, Steven MD
488 E Valley Pkwy Ste 211
Escondido, CA 92025
(760) 489-1458
Provider ID: 204438
License: A127156
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Popper, Steven MD
488 E Valley Pkwy Ste 201
Escondido, CA 92025
(760) 489-1458
Provider ID: 276725
License: A127156
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Trestman, Kenneth MD
488 E Valley Pkwy Ste 211
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 201
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Escondido, CA 92025
(760) 489-1458
Provider ID: 269147
License: G69663
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Bender, Frank MD
15611 Pomerado Rd Ste 580
Poway, CA 92064
(000) 000-0000
Provider ID: 270195
License: G33933
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Otoshi, James MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(760) 489-1458
Provider ID: 274767
License: G27763
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Popper, Steven MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3100
Provider ID: 129606
License: A127156
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Trestman, Kenneth MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3100
Provider ID: 269146
License: G69663
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 202
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92115
Le, Huan MD
5507 El Cajon Blvd # C
San Diego, CA 92115
(619) 582-1448
Provider ID: 27358
License: A76373
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: French,
Spanish, Vietnamese
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Radiation Oncology
CHULA VISTA
91911
Coleman, Lori MD
769 Medical Center Ct
Chula Vista, CA 91911
(619) 502-5851
Provider ID: 206393
License: G78635
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dewitt, Kelly MD
769 Medical Center Ct
Chula Vista, CA 91911
(619) 502-5851
Provider ID: 220043
License: A74873
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Jabbari, Siavash MD
751 Medical Center Ct
Chula Vista, CA 91911
(619) 502-5851
Provider ID: 204860
License: A99269
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Farsi
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 203
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Other Language: Kannada, Volpp, Paul MD
Jabbari, Siavash MD Spanish 769 Medical Center Ct
769 Medical Center Ct Cultural Competency: NR Chula Vista, CA 91911
Chula Vista, CA 91911 Accessibility: B; Members (619) 502-5851
(619) 502-5851 should call the provider’s Provider ID: 221102
Provider ID: 268783 office to discuss their License: A86307
License: A99269 accessibility needs when there Credentials and/or board
Credentials and/or board is limited access or when certification: No
certification: No accessibility indicators are not Accepting New Members: Yes
Accepting New Members: Yes present. Hours: M-SA 9AM-5PM
Hours: M-SA 9AM-5PM PTA: No
PTA: Yes Other Language: Spanish
Other Language: Farsi Uhl, Barry MD Cultural Competency: NR
Cultural Competency: NR 769 Medical Center Ct Accessibility: B; Members
Accessibility: B; Members Chula Vista, CA 91911 should call the provider’s
should call the provider’s (619) 502-5851 office to discuss their
office to discuss their Provider ID: 243527 accessibility needs when there
accessibility needs when there License: A71969 is limited access or when
is limited access or when Credentials and/or board accessibility indicators are not
accessibility indicators are not certification: No present.
present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No Weinstein, Geoffrey MD
Pejavar, Sunanda MD Other Language: Spanish 769 Medical Center Ct
769 Medical Center Ct Cultural Competency: NR Chula Vista, CA 91911
Chula Vista, CA 91911 Accessibility: B; Members (619) 502-5851
(619) 502-5851 should call the provider’s Provider ID: 200538
Provider ID: 221074 office to discuss their License: A54109
License: A103733 accessibility needs when there Credentials and/or board
Credentials and/or board is limited access or when certification: No
certification: No accessibility indicators are not Accepting New Members: Yes
Accepting New Members: Yes present. Hours: M-SA 9AM-5PM
Hours: M-SA 9AM-5PM PTA: No
PTA: No Other Language: Spanish
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 204
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Zentner, Phillip MD
769 Medical Center Ct
Chula Vista, CA 91911
(619) 502-5851
Provider ID: 204848
License: G83516
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Fuller, Donald MD
701 E Grand Ave Ste 200
Escondido, CA 92025
(760) 839-7370
Provider ID: 269237
License: G62532
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Ijaz, Tahir MD
701 E Grand Ave Ste 200
Escondido, CA 92025
(760) 839-7370
Provider ID: 269244
License: A52748
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Shirazi, Reza MD
701 E Grand Ave Ste 200
Escondido, CA 92025
(760) 839-7370
Provider ID: 269248
License: A95800
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Farsi,
Persian, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92029
Coleman, Lori MD
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 205
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
2125 Citracado Pkwy Ste 110 Accessibility: B; Members (760) 739-3371
Escondido, CA 92029 should call the provider’s Provider ID: 221076
(760) 735-7800 office to discuss their License: A103733
Provider ID: 221090 accessibility needs when there Credentials and/or board
License: G78635 is limited access or when certification: No
Credentials and/or board accessibility indicators are not Accepting New Members: Yes
certification: No present. Hours: M-SA 9AM-5PM
Accepting New Members: Yes PTA: No
Hours: M-SA 9AM-5PM Other Language: Kannada,
PTA: No Jabbari, Siavash MD Spanish
Other Language: Spanish 2125 Citracado Pkwy Ste 110 Cultural Competency: NR
Cultural Competency: NR Escondido, CA 92029 Accessibility: B; Members
Accessibility: B; Members (760) 739-3371 should call the provider’s
should call the provider’s Provider ID: 268786 office to discuss their
office to discuss their License: A99269 accessibility needs when there
accessibility needs when there Credentials and/or board is limited access or when
is limited access or when certification: No accessibility indicators are not
accessibility indicators are not Accepting New Members: Yes present.
present. Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi Uhl, Barry MD
Dewitt, Kelly MD Cultural Competency: NR 2125 Citracado Pkwy Ste 110
2125 Citracado Pkwy Ste 110 Accessibility: B; Members Escondido, CA 92029
Escondido, CA 92029 should call the provider’s (760) 739-3371
(760) 739-3371 office to discuss their Provider ID: 243529
Provider ID: 220044 accessibility needs when there License: A71969
License: A74873 is limited access or when Credentials and/or board
Credentials and/or board accessibility indicators are not certification: No
certification: No present. Accepting New Members: Yes
Accepting New Members: Yes Hours: M-SA 9AM-5PM
Hours: M-SA 9AM-5PM PTA: No
PTA: No Pejavar, Sunanda MD Other Language: Spanish
Other Language: Spanish 2125 Citracado Pkwy Ste 110 Cultural Competency: NR
Cultural Competency: NR Escondido, CA 92029 Accessibility: B; Members
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 206
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Volpp, Paul MD
2125 Citracado Pkwy Ste 110
Escondido, CA 92029
(760) 735-7800
Provider ID: 221103
License: A86307
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Weinstein, Geoffrey MD
2125 Citracado Pkwy Ste 110
Escondido, CA 92029
(760) 739-3371
Provider ID: 220041
License: A54109
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Zentner, Phillip MD
2125 Citracado Pkwy Ste 110
Escondido, CA 92029
(760) 735-7800
Provider ID: 221092
License: G83516
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92093
Mayadev, Jyoti MD
3855 Health Sciences Dr
La Jolla, CA 92093
(916) 734-8269
Provider ID: 269884
License: A109372
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mell, Loren MD
3855 Health Sciences Dr
La Jolla, CA 92093
(619) 543-3405
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 207
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Provider ID: 269944
License: A104704
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Murphy, Kevin MD
3855 Health Sciences Dr
La Jolla, CA 92093
(858) 822-6046
Provider ID: 269865
License: A82350
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Macewan, Iain MD
3855 Health Sciences Dr
La Jolla, CA 92093
(858) 822-4048
Provider ID: 255729
License: A129079
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rose, Brent MD
3855 Health Sciences Dr
La Jolla, CA 92093
(619) 341-3899
Provider ID: 269874
License: A142735
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sanghvi, Parag MD
3855 Health Sciences Dr
La Jolla, CA 92093
(619) 230-0400
Provider ID: 270038
License: A105184
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Gujarati,
Hindi, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 208
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Sharabi, Andrew MD
3855 Health Sciences Dr
La Jolla, CA 92093
(619) 543-1899
Provider ID: 269862
License: A136977
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Simpson, Daniel MD
3855 Health Sciences Dr
La Jolla, CA 92093
(858) 822-6040
Provider ID: 269852
License: A118377
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Coleman, Lori MD
5555 Grossmont Center Dr
La Mesa, CA 91942
(619) 644-4500
Provider ID: 221089
License: G78635
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dewitt, Kelly MD
5555 Grossmont Center Dr
La Mesa, CA 91942
(619) 740-4500
Provider ID: 206385
License: A74873
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Jabbari, Siavash MD
5555 Grossmont Center Dr
La Mesa, CA 91942
(619) 740-4500
Provider ID: 268785
License: A99269
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 209
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Cultural Competency: NR 5555 Grossmont Center Dr Accessibility: B; Members
Accessibility: B; Members La Mesa, CA 91942 should call the provider’s
should call the provider’s (619) 740-4500 office to discuss their
office to discuss their Provider ID: 204684 accessibility needs when there
accessibility needs when there License: A71969 is limited access or when
is limited access or when Credentials and/or board accessibility indicators are not
accessibility indicators are not certification: No present.
present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes Weinstein, Geoffrey MD
Pejavar, Sunanda MD Other Language: Spanish 5555 Grossmont Center Dr
5555 Grossmont Center Dr Cultural Competency: NR La Mesa, CA 91942
La Mesa, CA 91942 Accessibility: B; Members (619) 740-4500
(619) 740-4500 should call the provider’s Provider ID: 220040
Provider ID: 221075 office to discuss their License: A54109
License: A103733 accessibility needs when there Credentials and/or board
Credentials and/or board is limited access or when certification: No
certification: No accessibility indicators are not Accepting New Members: Yes
Accepting New Members: Yes present. Hours: M-SA 9AM-5PM
Hours: M-SA 9AM-5PM PTA: No
PTA: No Other Language: Spanish
Other Language: Kannada, Volpp, Paul MD Cultural Competency: NR
Spanish 5555 Grossmont Center Dr Accessibility: B; Members
Cultural Competency: NR La Mesa, CA 91942 should call the provider’s
Accessibility: B; Members (619) 740-4500 office to discuss their
should call the provider’s Provider ID: 221104 accessibility needs when there
office to discuss their License: A86307 is limited access or when
accessibility needs when there Credentials and/or board accessibility indicators are not
is limited access or when certification: No present.
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM
PTA: No Zentner, Phillip MD
Other Language: Spanish 5555 Grossmont Center Dr
Uhl, Barry MD Cultural Competency: NR La Mesa, CA 91942
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 210
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
(619) 740-8499
Provider ID: 221094
License: G83516
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92101
Fuller, Donald MD
2466 1st Ave # B
San Diego, CA 92101
(619) 230-0400
Provider ID: 269236
License: G62532
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92103
Ijaz, Tahir MD
3366 5th Ave
San Diego, CA 92103
(619) 230-0400
Provider ID: 269246
License: A52748
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Shirazi, Reza MD
3366 5th Ave
San Diego, CA 92103
(619) 230-0400
Provider ID: 269250
License: A95800
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Persian, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92121
Sanghvi, Parag MD
9730 Summers Ridge Rd
San Diego, CA 92121
(858) 549-7400
Provider ID: 270040
License: A105184
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Gujarati,
Hindi, Spanish
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 211
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92123
Coleman, Lori MD
3075 Health Center Dr
San Diego, CA 92123
(858) 939-5010
Provider ID: 221091
License: G78635
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dewitt, Kelly MD
3075 Health Center Dr
San Diego, CA 92123
(858) 939-5010
Provider ID: 220045
License: A74873
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Fuller, Donald MD
5395 Ruffin Rd Ste 103
San Diego, CA 92123
(858) 505-4100
Provider ID: 269238
License: G62532
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Ijaz, Tahir MD
5395 Ruffin Rd Ste 103
San Diego, CA 92123
(858) 505-4100
Provider ID: 269245
License: A52748
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Jabbari, Siavash MD
3075 Health Center Dr # 0
Level
San Diego, CA 92123
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 212
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
(858) 939-5010 should call the provider’s (858) 939-5010
Provider ID: 268784 office to discuss their Provider ID: 243528
License: A99269 accessibility needs when there License: A71969
Credentials and/or board is limited access or when Credentials and/or board
certification: No accessibility indicators are not certification: No
Accepting New Members: Yes present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM Hours: M-SA 9AM-5PM
PTA: No PTA: No
Other Language: Farsi Shirazi, Reza MD Other Language: Spanish
Cultural Competency: NR 5395 Ruffin Rd Ste 103 Cultural Competency: NR
Accessibility: B; Members San Diego, CA 92123 Accessibility: B; Members
should call the provider’s (858) 505-4100 should call the provider’s
office to discuss their Provider ID: 269249 office to discuss their
accessibility needs when there License: A95800 accessibility needs when there
is limited access or when Credentials and/or board is limited access or when
accessibility indicators are not certification: No accessibility indicators are not
present. Accepting New Members: Yes present.
Hours: M-SA 9AM-5PM
PTA: No
Pejavar, Sunanda MD Other Language: Farsi, Volpp, Paul MD
3075 Health Center Dr Persian, Spanish 3075 Health Center Dr
San Diego, CA 92123 Cultural Competency: NR San Diego, CA 92123
(858) 939-5010 Accessibility: B; Members (858) 939-5010
Provider ID: 221077 should call the provider’s Provider ID: 221105
License: A103733 office to discuss their License: A86307
Credentials and/or board accessibility needs when there Credentials and/or board
certification: No is limited access or when certification: No
Accepting New Members: Yes accessibility indicators are not Accepting New Members: Yes
Hours: M-SA 9AM-5PM present. Hours: M-SA 9AM-5PM
PTA: No PTA: No
Other Language: Kannada, Other Language: Spanish
Spanish Uhl, Barry MD Cultural Competency: NR
Cultural Competency: NR 3075 Health Center Dr Accessibility: B; Members
Accessibility: B; Members San Diego, CA 92123 should call the provider’s
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 213
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
office to discuss their License: G83516 accessibility needs when there
accessibility needs when there Credentials and/or board is limited access or when
is limited access or when certification: No accessibility indicators are not
accessibility indicators are not Accepting New Members: Yes present.
present. Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish Hattangadi Gluth, Jona MD
Weinstein, Geoffrey MD Cultural Competency: NR 16918 Dove Canyon Rd Ste
3075 Health Center Dr Accessibility: B; Members 103
San Diego, CA 92123 should call the provider’s San Diego, CA 92127
(858) 939-5010 office to discuss their (559) 447-4949
Provider ID: 220039 accessibility needs when there Provider ID: 254496
License: A54109 is limited access or when License: A122308
Credentials and/or board accessibility indicators are not Credentials and/or board
certification: No present. certification: No
Accepting New Members: Yes Accepting New Members: Yes
Hours: M-SA 9AM-5PM 92127 Hours: M-SA 9AM-5PM
PTA: No PTA: No
Other Language: Spanish Bruggeman, Andrew MD Cultural Competency: NR
Cultural Competency: NR 16918 Dove Canyon Rd Ste Accessibility: B; Members
Accessibility: B; Members 103 should call the provider’s
should call the provider’s San Diego, CA 92127 office to discuss their
office to discuss their (858) 649-5100 accessibility needs when there
accessibility needs when there Provider ID: 271007 is limited access or when
is limited access or when License: A126549 accessibility indicators are not
accessibility indicators are not Credentials and/or board present.
present. certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM Hoopes, David MD
Zentner, Phillip MD PTA: No 16918 Dove Canyon Rd Ste
3075 Health Center Dr Cultural Competency: NR 103
San Diego, CA 92123 Accessibility: B; Members San Diego, CA 92127
(858) 969-5010 should call the provider’s (559) 447-4949
Provider ID: 221093 office to discuss their Provider ID: 269725
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 214
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
License: C128063 accessibility needs when there License: A82350
Credentials and/or board is limited access or when Credentials and/or board
certification: No accessibility indicators are not certification: No
Accepting New Members: Yes present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM Hours: M-SA 9AM-5PM
PTA: No PTA: No
Other Language: Spanish Mell, Loren MD Other Language: Spanish
Cultural Competency: NR 16918 Dove Canyon Rd Ste Cultural Competency: NR
Accessibility: B; Members 103 Accessibility: B; Members
should call the provider’s San Diego, CA 92127 should call the provider’s
office to discuss their (559) 447-4949 office to discuss their
accessibility needs when there Provider ID: 255893 accessibility needs when there
is limited access or when License: A104704 is limited access or when
accessibility indicators are not Credentials and/or board accessibility indicators are not
present. certification: No present.
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
Mayadev, Jyoti MD PTA: No Macewan, Iain MD
16918 Dove Canyon Rd Ste Cultural Competency: NR 16918 Dove Canyon Rd Ste
103 Accessibility: B; Members 103
San Diego, CA 92127 should call the provider’s San Diego, CA 92127
(858) 649-5100 office to discuss their (858) 649-5100
Provider ID: 256153 accessibility needs when there Provider ID: 255730
License: A109372 is limited access or when License: A129079
Credentials and/or board accessibility indicators are not Credentials and/or board
certification: No present. certification: No
Accepting New Members: Yes Accepting New Members: Yes
Hours: M-SA 9AM-5PM Hours: M-SA 9AM-5PM
PTA: No Murphy, Kevin MD PTA: No
Other Language: Spanish 16918 Dove Canyon Rd Ste Cultural Competency: NR
Cultural Competency: NR 103 Accessibility: B; Members
Accessibility: B; Members San Diego, CA 92127 should call the provider’s
should call the provider’s (858) 649-5100 office to discuss their
office to discuss their Provider ID: 242618 accessibility needs when there
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 215
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
is limited access or when
accessibility indicators are not
present.
Rose, Brent MD
16918 Dove Canyon Rd Ste
103
San Diego, CA 92127
(858) 649-5100
Provider ID: 256307
License: A142735
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sandhu, Ajay MD
16918 Dove Canyon Rd Ste
103
San Diego, CA 92127
(559) 447-4949
Provider ID: 247978
License: A69947
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Hindi,
Punjabi
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sanghvi, Parag MD
16918 Dove Canyon Rd
San Diego, CA 92127
(858) 309-6585
Provider ID: 248043
License: A105184
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Gujarati,
Hindi, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sanghvi, Parag MD
16918 Dove Canyon Rd Ste
103
San Diego, CA 92127
(858) 309-6585
Provider ID: 270039
License: A105184
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Gujarati,
Hindi, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sharabi, Andrew MD
16918 Dove Canyon Rd Ste
103
San Diego, CA 92127
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 216
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
(858) 649-5100
Provider ID: 257024
License: A136977
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Simpson, Daniel MD
16918 Dove Canyon Rd Ste
103
San Diego, CA 92127
(858) 649-5100
Provider ID: 256193
License: A118377
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Radiology Diagnostic X-ray
CHULA VISTA
91910
Allen, Derrick MD
333 H St Ste 1095
Chula Vista, CA 91910
(619) 409-9119
Provider ID: 268362
License: A69840
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Buckley, David MD
333 H St Ste 1095
Chula Vista, CA 91910
(858) 658-6500
Provider ID: 243267
License: G57383
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sun, Alex MD
435 H St Ste 1
Chula Vista, CA 91910
(619) 543-2218
Provider ID: 268634
License: A133334
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 217
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ENCINITAS
92024
Allen, Derrick MD
477 N El Camino Real Ste A102
Encinitas, CA 92024
(760) 452-7150
Provider ID: 268358
License: A69840
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Buckley, David MD
477 N El Camino Real Ste A102
Encinitas, CA 92024
(760) 452-7150
Provider ID: 243264
License: G57383
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Allen, Derrick MD
4150 Regents Park Row Ste 195
La Jolla, CA 92037
(858) 622-6464
Provider ID: 268361
License: A69840
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Buckley, David MD
4150 Regents Park Row Ste 195
La Jolla, CA 92037
(858) 622-6464
Provider ID: 243265
License: G57383
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Liu, Jenna MD
5555 Grossmont Center Dr
La Mesa, CA 91942
(619) 461-1830
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 218
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Provider ID: 269009
License: A91263
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Naumann, Michael MD
8881 Fletcher Pkwy Ste 102
La Mesa, CA 91942
(619) 461-1830
Provider ID: 269664
License: A116596
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Naumann, Michael MD
8860 Center Dr Ste 100
La Mesa, CA 91942
(619) 460-2770
Provider ID: 269665
License: A116596
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sun, Alex MD
5555 Grossmont Center Dr
La Mesa, CA 91942
(619) 740-4008
Provider ID: 268633
License: A133334
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
OCEANSIDE
92056
Allen, Derrick MD
3601 Vista Way
Oceanside, CA 92056
(760) 631-7505
Provider ID: 268360
License: A69840
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 219
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
POWAY
92064
Allen, Derrick MD
12620 Monte Vista Rd Ste A
Poway, CA 92064
(858) 487-9729
Provider ID: 268359
License: A69840
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Buckley, David MD
12620 Monte Vista Rd Ste A
Poway, CA 92064
(858) 487-9729
Provider ID: 243262
License: G57383
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92103
Allen, Derrick MD
4077 5th Ave
San Diego, CA 92103
(888) 685-4016
Provider ID: 268355
License: A69840
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Buckley, David MD
150 W Washington St
San Diego, CA 92103
(858) 658-6500
Provider ID: 243260
License: G57383
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Buckley, David MD
550 Washington St Ste 200
San Diego, CA 92103
(619) 260-7225
Provider ID: 243268
License: G57383
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 220
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sun, Alex MD
200 W Arbor Dr
San Diego, CA 92103
(619) 543-2218
Provider ID: 268632
License: A133334
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92113
Allen, Derrick MD
1809 National Ave Ste 2104
San Diego, CA 92113
should call the provider’s
office to discuss their
(858) 658-6500
Provider ID: 268354
accessibility needs when there
is limited access or when
License: A69840 accessibility indicators are not
Credentials and/or board
certification: No
present.
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Buckley, David MD
6386 Alvarado Ct Ste 121
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
San Diego, CA 92120
(619) 229-2299
Provider ID: 243266
office to discuss their License: G57383
accessibility needs when there
is limited access or when
Credentials and/or board
certification: No
accessibility indicators are not
present.
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
92120
Allen, Derrick MD
6386 Alvarado Ct Ste 121
San Diego, CA 92120
(619) 229-2299
Provider ID: 268357
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
License: A69840
Credentials and/or board
certification: No
accessibility indicators are not
present.
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Ihs Radiology Medical Group
Inc,
Cultural Competency: NR
Accessibility: B; Members
6386 Alvarado Ct Ste 121
San Diego, CA 92120
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 221
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
(619) 229-2299
NPI#: 1497148456
Provider ID: 200459
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92123
Buckley, David MD
3939 Ruffin Rd Ste 102
San Diego, CA 92123
(858) 658-6500
Provider ID: 243261
License: G57383
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SANTEE
92071
Naumann, Michael MD
9640 Mission Gorge Rd Ste H
Santee, CA 92071
(619) 258-8552
Provider ID: 269663
License: A116596
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Radiology Diagnostic
CHULA VISTA
91910
Tiefenbrun, Jonathan MD
340 4th Ave Ste 4
Chula Vista, CA 91910
(619) 427-1144
Provider ID: 66135
License: G85951
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: French,
Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Mortezaie, Alan MD
5555 Grossmont Center Dr
La Mesa, CA 91942
(661) 326-9600
Provider ID: 268883
License: A116100
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 222
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Tiefenbrun, Jonathan MD
8851 Center Dr Ste 505
La Mesa, CA 91942
(619) 461-3880
Provider ID: 268966
License: G85951
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: French,
Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Radiology
CHULA VISTA
91910
Doemeny, John MD
333 H St Ste 1095
Chula Vista, CA 91910
(858) 658-6500
Provider ID: 269755
License: G50925
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Franke, Mark MD
333 H St Ste 1095
Chula Vista, CA 91910
(858) 658-6500
Provider ID: 269639
License: A118792
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Lubisich, John MD
333 H St Ste 1095
Chula Vista, CA 91910
(858) 658-6500
Provider ID: 244952
License: G77575
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 223
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Moffit, Brian MD Cultural Competency: NR Doemeny, John MD
333 H St Ste 1095
Chula Vista, CA 91910
(858) 658-6500
Provider ID: 269533
License: G51551
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Tena, Rowena MD
333 H St Ste 1095
Chula Vista, CA 91910
(858) 658-6500
Provider ID: 269829
License: A69607
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
91911
Hawley, Daniel MD
751 Medical Center Ct
Chula Vista, CA 91911
(619) 502-5851
Provider ID: 268857
License: A114748
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ENCINITAS
92024
477 N El Camino Real Ste A102
Encinitas, CA 92024
(760) 452-7150
Provider ID: 269750
License: G50925
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Franke, Mark MD
477 N El Camino Real Ste A102
Encinitas, CA 92024
(760) 452-7150
Provider ID: 269635
License: A118792
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 224
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Moffit, Brian MD
477 N El Camino Real Ste A102
Encinitas, CA 92024
(760) 452-7150
Provider ID: 269524
License: G51551
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Schwartzberg, Ross MD
477 N El Camino Real Ste A102
Encinitas, CA 92024
(760) 452-7150
Provider ID: 245629
License: G72997
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Tena, Rowena MD
477 N El Camino Real Ste 102
Encinitas, CA 92024
(760) 452-7150
Provider ID: 269824
License: A69607
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Doemeny, John MD
4150 Regents Park Row Ste 195
La Jolla, CA 92037
(858) 622-6464
Provider ID: 269748
License: G50925
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Franke, Mark MD
4150 Regents Park Row Ste 195
La Jolla, CA 92037
(858) 622-6464
Provider ID: 269633
License: A118792
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 225
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Moffit, Brian MD
4150 Regents Park Row Ste 195
La Jolla, CA 92037
(858) 622-6464
Provider ID: 269527
License: G51551
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Schwartzberg, Ross MD
4150 Regents Park Row Ste 195
La Jolla, CA 92037
(858) 622-6464
Provider ID: 245630
License: G72997
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Tena, Rowena MD
4150 Regents Park Row Ste 195
La Jolla, CA 92037
(858) 622-6464
Provider ID: 269826
License: A69607
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Brannigan, Thomas MD
5555 Grossmont Center Dr
La Mesa, CA 91942
(619) 460-2770
Provider ID: 269041
License: G65789
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 226
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Cultural Competency: NR (508) 295-7271
Chang, Weiling MD Accessibility: B; Members Provider ID: 268900
5555 Grossmont Center Dr should call the provider’s License: C131942
La Mesa, CA 91942 office to discuss their Credentials and/or board
(619) 460-2770 accessibility needs when there certification: No
Provider ID: 269040 is limited access or when Accepting New Members: Yes
License: A90535 accessibility indicators are not Hours: M-SA 9AM-5PM
Credentials and/or board present. PTA: No
certification: No Other Language: Vietnamese
Accepting New Members: Yes Cultural Competency: NR
Hours: M-SA 9AM-5PM Ellison, Jon MD Accessibility: B; Members
PTA: No 5555 Grossmont Center Dr should call the provider’s
Cultural Competency: NR La Mesa, CA 91942 office to discuss their
Accessibility: B; Members (619) 460-2774 accessibility needs when there
should call the provider’s Provider ID: 268993 is limited access or when
office to discuss their License: A117199 accessibility indicators are not
accessibility needs when there Credentials and/or board present.
is limited access or when certification: No
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM Honowitz, Scott MD
PTA: No 5555 Grossmont Center Dr
Cultural Competency: NR La Mesa, CA 91942
Ellison, Harry MD Accessibility: B; Members (508) 295-7271
5555 Grossmont Center Dr Ste should call the provider’s Provider ID: 268846
1 office to discuss their License: A134287
La Mesa, CA 91942 accessibility needs when there Credentials and/or board
(619) 740-5100 is limited access or when certification: No
Provider ID: 268985 accessibility indicators are not Accepting New Members: Yes
License: G50309 present. Hours: M-SA 9AM-5PM
Credentials and/or board PTA: No
certification: No Cultural Competency: NR
Accepting New Members: Yes Ha, Tuan MD Accessibility: B; Members
Hours: M-SA 9AM-5PM 5555 Grossmont Center Dr should call the provider’s
PTA: No La Mesa, CA 91942 office to discuss their
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 227
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Jacobsen, James MD
8881 Fletcher Pkwy Ste 102
La Mesa, CA 91942
(619) 460-2770
Provider ID: 243974
License: A87878
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Jacobsen, James MD
8860 Center Dr Ste 100
La Mesa, CA 91942
(619) 460-2770
Provider ID: 243975
License: A87878
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Lance, Valentin MD
5555 Grossmont Center Dr
La Mesa, CA 91942
(800) 841-5200
Provider ID: 268974
License: A118759
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Moore, Brian MD
8881 Fletcher Pkwy Ste 102
La Mesa, CA 91942
(619) 460-2770
Provider ID: 243959
License: G68336
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Moore, Brian MD
8860 Center Dr Ste 100
La Mesa, CA 91942
(619) 460-2770
Provider ID: 243960
License: G68336
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 228
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Trout, Tere MD
5555 Grossmont Center Dr
La Mesa, CA 91942
(619) 460-2770
Provider ID: 268982
License: G70276
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Urioste, Alexander MD
8860 Center Dr Ste 100
La Mesa, CA 91942
(619) 460-2770
Provider ID: 269251
License: A78795
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Venkatesh, Vijay MD
8860 Center Dr Ste 100
La Mesa, CA 91942
(619) 740-5100
Provider ID: 269659
License: A94476
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Venkatesh, Vijay MD
8881 Fletcher Pkwy Ste 102
La Mesa, CA 91942
(619) 461-1830
Provider ID: 269660
License: A94476
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Viets, Ryan MD
5555 Grossmont Center Dr
La Mesa, CA 91942
(619) 740-5100
Provider ID: 268951
License: A125809
Credentials and/or board
certification: No
Accepting New Members: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 229
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
OCEANSIDE
92056
Doemeny, John MD
3601 Vista Way Ste 101
Oceanside, CA 92056
(760) 631-7505
Provider ID: 269751
License: G50925
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Franke, Mark MD
3601 Vista Way Ste 101
Oceanside, CA 92056
(760) 631-7505
Provider ID: 269636
License: A118792
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Moffit, Brian MD
3601 Vista Way Ste 101 Bldg A
Oceanside, CA 92056
(760) 631-7505
Provider ID: 269529
License: G51551
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Tena, Rowena MD
3601 Vista Way Ste 101
Oceanside, CA 92056
(760) 631-7505
Provider ID: 269823
License: A69607
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 230
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Doemeny, John MD should call the provider’s Provider ID: 245627
12620 Monte Vista Rd Ste A office to discuss their License: G72997
Poway, CA 92064 accessibility needs when there Credentials and/or board
(858) 487-9729 is limited access or when certification: No
Provider ID: 269749 accessibility indicators are not Accepting New Members: Yes
License: G50925 present. Hours: M-SA 9AM-5PM
Credentials and/or board PTA: No
certification: No Cultural Competency: NR
Accepting New Members: Yes Moffit, Brian MD Accessibility: B; Members
Hours: M-SA 9AM-5PM 12620 Monte Vista Rd Ste A should call the provider’s
PTA: No Poway, CA 92064 office to discuss their
Cultural Competency: NR (858) 487-9729 accessibility needs when there
Accessibility: B; Members Provider ID: 269528 is limited access or when
should call the provider’s License: G51551 accessibility indicators are not
office to discuss their Credentials and/or board present.
accessibility needs when there certification: No
is limited access or when Accepting New Members: Yes
accessibility indicators are not Hours: M-SA 9AM-5PM Tena, Rowena MD
present. PTA: No 12620 Monte Vista Rd Ste A
Other Language: Spanish Poway, CA 92064
Cultural Competency: NR (858) 487-9729
Franke, Mark MD Accessibility: B; Members Provider ID: 269825
12620 Monte Vista Rd Ste A should call the provider’s License: A69607
Poway, CA 92064 office to discuss their Credentials and/or board
(858) 487-9729 accessibility needs when there certification: No
Provider ID: 269634 is limited access or when Accepting New Members: Yes
License: A118792 accessibility indicators are not Hours: M-SA 9AM-5PM
Credentials and/or board present. PTA: No
certification: No Other Language: Spanish
Accepting New Members: Yes Cultural Competency: NR
Hours: M-SA 9AM-5PM Schwartzberg, Ross MD Accessibility: B; Members
PTA: No 12620 Monte Vista Rd Ste A should call the provider’s
Cultural Competency: NR Poway, CA 92064 office to discuss their
Accessibility: B; Members (858) 487-9729 accessibility needs when there
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 231
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92102
Rattner, Zachary MD
995 Gateway Center Way Ste
207
San Diego, CA 92102
(619) 263-9729
Provider ID: 269895
License: G86843
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92103
Allen, Derrick MD
150 W Washington St
San Diego, CA 92103
(619) 295-9729
Provider ID: 269614
License: A69840
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Allen, Derrick MD
550 Washington St Ste 200
San Diego, CA 92103
(619) 260-7225
Provider ID: 269617
License: A69840
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Chou, Eric MD
150 W Washington St
San Diego, CA 92103
(858) 658-6500
Provider ID: 243395
License: A96095
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Chou, Eric MD
4077 5th Ave
San Diego, CA 92103
(619) 819-6501
Provider ID: 243396
License: A96095
Credentials and/or board
certification: No
Accepting New Members: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 232
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Hours: M-SA 9AM-5PM 150 W Washington St office to discuss their
PTA: No San Diego, CA 92103 accessibility needs when there
Cultural Competency: NR (858) 658-6500 is limited access or when
Accessibility: B; Members Provider ID: 269746 accessibility indicators are not
should call the provider’s License: G50925 present.
office to discuss their Credentials and/or board
accessibility needs when there certification: No
is limited access or when Accepting New Members: Yes Doemeny, John MD
accessibility indicators are not Hours: M-SA 9AM-5PM 550 Washington St Ste 200
present. PTA: No San Diego, CA 92103
Cultural Competency: NR (619) 260-7225
Accessibility: B; Members Provider ID: 269757
Cooper, James MD should call the provider’s License: G50925
4077 5th Ave office to discuss their Credentials and/or board
San Diego, CA 92103 accessibility needs when there certification: No
(619) 294-8111 is limited access or when Accepting New Members: Yes
Provider ID: 242475 accessibility indicators are not Hours: M-SA 9AM-5PM
License: A62473 present. PTA: No
Credentials and/or board Cultural Competency: NR
certification: No Accessibility: B; Members
Accepting New Members: Yes Doemeny, John MD should call the provider’s
Hours: M-SA 9AM-5PM 4077 5th Ave office to discuss their
PTA: No San Diego, CA 92103 accessibility needs when there
Cultural Competency: NR (619) 294-8111 is limited access or when
Accessibility: B; Members Provider ID: 269756 accessibility indicators are not
should call the provider’s License: G50925 present.
office to discuss their Credentials and/or board
accessibility needs when there certification: No
is limited access or when Accepting New Members: Yes Franke, Mark MD
accessibility indicators are not Hours: M-SA 9AM-5PM 150 W Washington St
present. PTA: No San Diego, CA 92103
Cultural Competency: NR (858) 658-6500
Accessibility: B; Members Provider ID: 269640
Doemeny, John MD should call the provider’s License: A118792
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 233
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Credentials and/or board Other Language: Spanish
certification: No Cultural Competency: NR
Accepting New Members: Yes Franke, Mark MD Accessibility: B; Members
Hours: M-SA 9AM-5PM 550 Washington St Ste 200 should call the provider’s
PTA: No San Diego, CA 92103 office to discuss their
Cultural Competency: NR (619) 260-7225 accessibility needs when there
Accessibility: B; Members Provider ID: 269642 is limited access or when
should call the provider’s License: A118792 accessibility indicators are not
office to discuss their Credentials and/or board present.
accessibility needs when there certification: No
is limited access or when Accepting New Members: Yes
accessibility indicators are not Hours: M-SA 9AM-5PM Moffit, Brian MD
present. PTA: No 550 Washington St Ste 200
Cultural Competency: NR San Diego, CA 92103
Accessibility: B; Members (619) 260-7225
Franke, Mark MD should call the provider’s Provider ID: 269534
4077 5th Ave office to discuss their License: G51551
San Diego, CA 92103 accessibility needs when there Credentials and/or board
(619) 294-8111 is limited access or when certification: No
Provider ID: 269641 accessibility indicators are not Accepting New Members: Yes
License: A118792 present. Hours: M-SA 9AM-5PM
Credentials and/or board PTA: No
certification: No Other Language: Spanish
Accepting New Members: Yes Moffit, Brian MD Cultural Competency: NR
Hours: M-SA 9AM-5PM 150 W Washington St Accessibility: B; Members
PTA: No San Diego, CA 92103 should call the provider’s
Cultural Competency: NR (858) 658-6500 office to discuss their
Accessibility: B; Members Provider ID: 269525 accessibility needs when there
should call the provider’s License: G51551 is limited access or when
office to discuss their Credentials and/or board accessibility indicators are not
accessibility needs when there certification: No present.
is limited access or when Accepting New Members: Yes
accessibility indicators are not Hours: M-SA 9AM-5PM
present. PTA: No Moffit, Brian MD
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 234
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
4077 5th Ave should call the provider’s License: G72997
San Diego, CA 92103 office to discuss their Credentials and/or board
(619) 294-8111 accessibility needs when there certification: No
Provider ID: 269536 is limited access or when Accepting New Members: Yes
License: G51551 accessibility indicators are not Hours: M-SA 9AM-5PM
Credentials and/or board present. PTA: No
certification: No Cultural Competency: NR
Accepting New Members: Yes Accessibility: B; Members
Hours: M-SA 9AM-5PM Schwartzberg, Ross MD should call the provider’s
PTA: No 150 W Washington St office to discuss their
Other Language: Spanish San Diego, CA 92103 accessibility needs when there
Cultural Competency: NR (619) 295-9729 is limited access or when
Accessibility: B; Members Provider ID: 245624 accessibility indicators are not
should call the provider’s License: G72997 present.
office to discuss their Credentials and/or board
accessibility needs when there certification: No
is limited access or when Accepting New Members: Yes Schwartzberg, Ross MD
accessibility indicators are not Hours: M-SA 9AM-5PM 550 Washington St Ste 200
present. PTA: No San Diego, CA 92103
Cultural Competency: NR (619) 260-7225
Accessibility: B; Members Provider ID: 245632
Sabir, Sharjeel MD should call the provider’s License: G72997
4077 5th Ave office to discuss their Credentials and/or board
San Diego, CA 92103 accessibility needs when there certification: No
(619) 862-6500 is limited access or when Accepting New Members: Yes
Provider ID: 269857 accessibility indicators are not Hours: M-SA 9AM-5PM
License: C158962 present. PTA: No
Credentials and/or board Cultural Competency: NR
certification: No Accessibility: B; Members
Accepting New Members: Yes Schwartzberg, Ross MD should call the provider’s
Hours: M-SA 9AM-5PM 4077 5th Ave office to discuss their
PTA: No San Diego, CA 92103 accessibility needs when there
Cultural Competency: NR (619) 294-8111 is limited access or when
Accessibility: B; Members Provider ID: 245626 accessibility indicators are not
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 235
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
present. Hours: M-SA 9AM-5PM 92113 PTA: No
Other Language: Spanish Doemeny, John MD
Tena, Rowena MD Cultural Competency: NR 1809 National Ave Ste 2104
150 W Washington St Accessibility: B; Members San Diego, CA 92113
San Diego, CA 92103 should call the provider’s (858) 658-6500
(858) 658-6500 office to discuss their Provider ID: 269753
Provider ID: 269822 accessibility needs when there License: G50925
License: A69607 is limited access or when Credentials and/or board
Credentials and/or board accessibility indicators are not certification: No
certification: No present. Accepting New Members: Yes
Accepting New Members: Yes Hours: M-SA 9AM-5PM
Hours: M-SA 9AM-5PM PTA: No
PTA: No Tena, Rowena MD Cultural Competency: NR
Other Language: Spanish 550 Washington St Ste 200 Accessibility: B; Members
Cultural Competency: NR San Diego, CA 92103 should call the provider’s
Accessibility: B; Members (619) 260-7225 office to discuss their
should call the provider’s Provider ID: 269832 accessibility needs when there
office to discuss their License: A69607 is limited access or when
accessibility needs when there Credentials and/or board accessibility indicators are not
is limited access or when certification: No present.
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM
PTA: No Franke, Mark MD
Other Language: Spanish 1809 National Ave Ste 2104
Tena, Rowena MD Cultural Competency: NR San Diego, CA 92113
4077 5th Ave Accessibility: B; Members (858) 658-6500
San Diego, CA 92103 should call the provider’s Provider ID: 269638
(619) 294-8111 office to discuss their License: A118792
Provider ID: 269830 accessibility needs when there Credentials and/or board
License: A69607 is limited access or when certification: No
Credentials and/or board accessibility indicators are not Accepting New Members: Yes
certification: No present. Hours: M-SA 9AM-5PM
Accepting New Members: Yes PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 236
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Cultural Competency: NR San Diego, CA 92113 should call the provider’s
Accessibility: B; Members (858) 658-6500 office to discuss their
should call the provider’s Provider ID: 265583 accessibility needs when there
office to discuss their License: A69607 is limited access or when
accessibility needs when there Credentials and/or board accessibility indicators are not
is limited access or when certification: No present.
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM
PTA: No Franke, Mark MD
Other Language: Spanish 6386 Alvarado Ct Ste 121
Moffit, Brian MD Cultural Competency: NR San Diego, CA 92120
1809 National Ave Ste 2104 Accessibility: B; Members (619) 229-2299
San Diego, CA 92113 should call the provider’s Provider ID: 269637
(858) 658-6500 office to discuss their License: A118792
Provider ID: 269531 accessibility needs when there Credentials and/or board
License: G51551 is limited access or when certification: No
Credentials and/or board accessibility indicators are not Accepting New Members: Yes
certification: No present. Hours: M-SA 9AM-5PM
Accepting New Members: Yes PTA: No
Hours: M-SA 9AM-5PM 92120 Cultural Competency: NR
PTA: No Accessibility: B; Members
Other Language: Spanish Doemeny, John MD should call the provider’s
Cultural Competency: NR 6386 Alvarado Ct Ste 121 office to discuss their
Accessibility: B; Members San Diego, CA 92120 accessibility needs when there
should call the provider’s (619) 229-2299 is limited access or when
office to discuss their Provider ID: 269752 accessibility indicators are not
accessibility needs when there License: G50925 present.
is limited access or when Credentials and/or board
accessibility indicators are not certification: No
present. Accepting New Members: Yes Lubisich, John MD
Hours: M-SA 9AM-5PM 6655 Alvarado Rd
PTA: No San Diego, CA 92120
Tena, Rowena MD Cultural Competency: NR (866) 558-4320
1809 National Ave Ste 2104 Accessibility: B; Members Provider ID: 244953
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 237
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
License: G77575 accessibility indicators are not Hours: M-SA 9AM-5PM
Credentials and/or board present. PTA: No
certification: No Other Language: Spanish
Accepting New Members: Yes Cultural Competency: NR
Hours: M-SA 9AM-5PM Schwartzberg, Ross MD Accessibility: B; Members
PTA: No 6386 Alvarado Ct Ste 121 should call the provider’s
Cultural Competency: NR San Diego, CA 92120 office to discuss their
Accessibility: B; Members (619) 229-2299 accessibility needs when there
should call the provider’s Provider ID: 245631 is limited access or when
office to discuss their License: G72997 accessibility indicators are not
accessibility needs when there Credentials and/or board present.
is limited access or when certification: No
accessibility indicators are not Accepting New Members: Yes 92123 present. Hours: M-SA 9AM-5PM
PTA: No Allen, Derrick MD
Cultural Competency: NR 3939 Ruffin Rd Ste 102
Moffit, Brian MD Accessibility: B; Members San Diego, CA 92123
6386 Alvarado Ct Ste 121 should call the provider’s (858) 658-6500
San Diego, CA 92120 office to discuss their Provider ID: 269615
(619) 229-2299 accessibility needs when there License: A69840
Provider ID: 269530 is limited access or when Credentials and/or board
License: G51551 accessibility indicators are not certification: No
Credentials and/or board present. Accepting New Members: Yes
certification: No Hours: M-SA 9AM-5PM
Accepting New Members: Yes PTA: No
Hours: M-SA 9AM-5PM Tena, Rowena MD Cultural Competency: NR
PTA: No 6386 Alvarado Ct Ste 121 Accessibility: B; Members
Other Language: Spanish San Diego, CA 92120 should call the provider’s
Cultural Competency: NR (619) 229-2299 office to discuss their
Accessibility: B; Members Provider ID: 269828 accessibility needs when there
should call the provider’s License: A69607 is limited access or when
office to discuss their Credentials and/or board accessibility indicators are not
accessibility needs when there certification: No present.
is limited access or when Accepting New Members: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 238
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Accessibility: B; Members Provider ID: 244954
Chou, Eric MD should call the provider’s License: G77575
3939 Ruffin Rd Ste 102 office to discuss their Credentials and/or board
San Diego, CA 92123 accessibility needs when there certification: No
(858) 658-6500 is limited access or when Accepting New Members: Yes
Provider ID: 243397 accessibility indicators are not Hours: M-SA 9AM-5PM
License: A96095 present. PTA: No
Credentials and/or board Cultural Competency: NR
certification: No Accessibility: B; Members
Accepting New Members: Yes Franke, Mark MD should call the provider’s
Hours: M-SA 9AM-5PM 3939 Ruffin Rd Ste 102 office to discuss their
PTA: No San Diego, CA 92123 accessibility needs when there
Cultural Competency: NR (858) 658-6500 is limited access or when
Accessibility: B; Members Provider ID: 269632 accessibility indicators are not
should call the provider’s License: A118792 present.
office to discuss their Credentials and/or board
accessibility needs when there certification: No
is limited access or when Accepting New Members: Yes Moffit, Brian MD
accessibility indicators are not Hours: M-SA 9AM-5PM 3939 Ruffin Rd Ste 102
present. PTA: No San Diego, CA 92123
Cultural Competency: NR (858) 658-6500
Accessibility: B; Members Provider ID: 269526
Doemeny, John MD should call the provider’s License: G51551
3939 Ruffin Rd Ste 102 office to discuss their Credentials and/or board
San Diego, CA 92123 accessibility needs when there certification: No
(858) 658-6500 is limited access or when Accepting New Members: Yes
Provider ID: 269747 accessibility indicators are not Hours: M-SA 9AM-5PM
License: G50925 present. PTA: No
Credentials and/or board Other Language: Spanish
certification: No Cultural Competency: NR
Accepting New Members: Yes Lubisich, John MD Accessibility: B; Members
Hours: M-SA 9AM-5PM 3939 Ruffin Rd Ste 102 should call the provider’s
PTA: No San Diego, CA 92123 office to discuss their
Cultural Competency: NR (858) 658-6500 accessibility needs when there
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 239
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
is limited access or when
accessibility indicators are not
present.
Schwartzberg, Ross MD
3939 Ruffin Rd Ste 102
San Diego, CA 92123
(858) 658-6500
Provider ID: 245625
License: G72997
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Tena, Rowena MD
3939 Ruffin Rd Ste 102
San Diego, CA 92123
(858) 658-6500
Provider ID: 269827
License: A69607
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92127
Straka, Christopher MD
16918 Dove Canyon Rd Ste
103
San Diego, CA 92127
(858) 649-5100
Provider ID: 276875
License: A145989
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SANTEE
92071
Jacobsen, James MD
9640 Mission Gorge Rd Ste H
Santee, CA 92071
(619) 460-2770
Provider ID: 243976
License: A87878
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Moore, Brian MD
9640 Mission Gorge Rd Ste H
Santee, CA 92071
(619) 460-2770
Provider ID: 243961
License: G68336
Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 240
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Venkatesh, Vijay MD
9640 Mission Gorge Rd Ste H
Santee, CA 92071
(619) 460-2770
Provider ID: 269661
License: A94476
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
VISTA
92084
Allen, Derrick MD
1000 Vale Terrace Dr
Vista, CA 92084
(858) 888-4444
Provider ID: 269616
License: A69840
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Doemeny, John MD
1000 Vale Terrace Dr
Vista, CA 92084
(858) 888-4444
Provider ID: 269754
License: G50925
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Moffit, Brian MD
1000 Vale Terrace Dr
Vista, CA 92084
(858) 888-4444
Provider ID: 269532
License: G51551
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 241
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Registered Dietitian /
Nutritionist
ESCONDIDO
92025
Baker, Janice RD
488 E Valley Pkwy Ste 211
Escondido, CA 92025
(760) 294-2266
Provider ID: 269136
License: 647205
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Baker, Janice RD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3150
Provider ID: 269135
License: 647205
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Registered Physical Therapist
CARLSBAD
92008
Alaby, Amy PT
3070 Madison St
Carlsbad, CA 92008
(760) 591-7750
Provider ID: 269217
License: PT42087
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Ambrose, Christopher PT
3070 Madison St
Carlsbad, CA 92008
(760) 434-6100
Provider ID: 248010
License: PT26311
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Baker, Lisa PT
3070 Madison St
Carlsbad, CA 92008
(760) 591-7750
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 242
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Provider ID: 269094 accessibility indicators are not Hours: M-SA 9AM-5PM
License: PT22824 present. PTA: No
Credentials and/or board Cultural Competency: NR
certification: No Accessibility: B; Members
Accepting New Members: Yes Boutelle, David RPT should call the provider’s
Hours: M-SA 9AM-5PM 3070 Madison St office to discuss their
PTA: No Carlsbad, CA 92008 accessibility needs when there
Cultural Competency: NR (760) 434-6100 is limited access or when
Accessibility: B; Members Provider ID: 248307 accessibility indicators are not
should call the provider’s License: PT12422 present.
office to discuss their Credentials and/or board
accessibility needs when there certification: No
is limited access or when Accepting New Members: Yes Oliveros, Yunnuen PT
accessibility indicators are not Hours: M-SA 9AM-5PM 3070 Madison St
present. PTA: Yes Carlsbad, CA 92008
Cultural Competency: NR (760) 434-6100
Accessibility: B; Members Provider ID: 277464
Boutelle, Barbara RPT should call the provider’s License: PT294386
3070 Madison St office to discuss their Credentials and/or board
Carlsbad, CA 92008 accessibility needs when there certification: No
(760) 434-6100 is limited access or when Accepting New Members: Yes
Provider ID: 246318 accessibility indicators are not Hours: M-SA 9AM-5PM
License: PT12716 present. PTA: No
Credentials and/or board Cultural Competency: NR
certification: No Accessibility: B; Members
Accepting New Members: Yes Mcgee, Jacqueline PT should call the provider’s
Hours: M-SA 9AM-5PM 3070 Madison St office to discuss their
PTA: Yes Carlsbad, CA 92008 accessibility needs when there
Cultural Competency: NR (760) 434-6100 is limited access or when
Accessibility: B; Members Provider ID: 252472 accessibility indicators are not
should call the provider’s License: PT294790 present.
office to discuss their Credentials and/or board
accessibility needs when there certification: No CHULA VISTA is limited access or when Accepting New Members: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 243
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Cultural Competency: NR (619) 585-710491910 Accessibility: B; Members Provider ID: 268947
Bush, Nathanael PT should call the provider’s License: PT295601
1020 Tierra Del Rey Ste A1 office to discuss their Credentials and/or board
Chula Vista, CA 91910 accessibility needs when there certification: No
(619) 585-7104 is limited access or when Accepting New Members: Yes
Provider ID: 268896 accessibility indicators are not Hours: M-SA 9AM-5PM
License: PT295464 present. PTA: No
Credentials and/or board Cultural Competency: NR
certification: No Accessibility: B; Members
Accepting New Members: Yes Crittenden, Jennifer PT should call the provider’s
Hours: M-SA 9AM-5PM 480 Fourth Ave Ste 509 office to discuss their
PTA: No Chula Vista, CA 91910 accessibility needs when there
Cultural Competency: NR (619) 651-9760 is limited access or when
Accessibility: B; Members Provider ID: 268695 accessibility indicators are not
should call the provider’s License: PT39118 present.
office to discuss their Credentials and/or board
accessibility needs when there certification: No
is limited access or when Accepting New Members: Yes Dones, Gina RPT
accessibility indicators are not Hours: M-SA 9AM-5PM 1020 Tierra Del Rey Ste A-1
present. PTA: No Chula Vista, CA 91910
Cultural Competency: NR (619) 585-7104
Accessibility: B; Members Provider ID: 268856
Chang, Robert PT should call the provider’s License: PT39455
1020 Tierra Del Rey Ste A1 office to discuss their Credentials and/or board
Chula Vista, CA 91910 accessibility needs when there certification: No
(619) 585-7104 is limited access or when Accepting New Members: Yes
Provider ID: 268910 accessibility indicators are not Hours: M-SA 9AM-5PM
License: PT291836 present. PTA: No
Credentials and/or board Cultural Competency: NR
certification: No Accessibility: B; Members
Accepting New Members: Yes Dicenso, Philip PT should call the provider’s
Hours: M-SA 9AM-5PM 1020 Tierra Del Rey Ste A1 office to discuss their
PTA: No Chula Vista, CA 91910 accessibility needs when there
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 244
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
is limited access or when
accessibility indicators are not
present.
Hastings, Natasha PT
1020 Tierra Del Rey Ste A1
Chula Vista, CA 91910
(619) 585-7104
Provider ID: 268895
License: PT291371
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Introcaso, Brianna PT
1020 Tierra Del Rey Ste A1
Chula Vista, CA 91910
(619) 585-7104
Provider ID: 268948
License: PT293801
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Langworthy, Matthew PT
1020 Tierra Del Rey Ste A1
Chula Vista, CA 91910
(619) 585-7104
Provider ID: 268866
License: PT294466
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Morigeau, Samantha PT
1020 Tierra Del Rey Ste A1
Chula Vista, CA 91910
(619) 585-7104
Provider ID: 269051
License: PT42287
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Marsolini, Kayleigh PT
1020 Tierra Del Rey Ste A-1
Chula Vista, CA 91910
(619) 585-7104
Provider ID: 268949
License: PT294481
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 245
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Accessibility: B; Members Provider ID: 268902 is limited access or when
should call the provider’s License: PT295612 accessibility indicators are not
office to discuss their Credentials and/or board present.
accessibility needs when there certification: No
is limited access or when Accepting New Members: Yes
accessibility indicators are not Hours: M-SA 9AM-5PM Santamaria, Jennifer PT
present. PTA: No 1392 E Palomar St Ste 503
Cultural Competency: NR Chula Vista, CA 91913
Accessibility: B; Members (619) 482-3000
Oliveros, Yunnuen PT should call the provider’s Provider ID: 243544
1020 Tierra Del Rey Ste A1 office to discuss their License: PT296313
Chula Vista, CA 91910 accessibility needs when there Credentials and/or board
(619) 585-7104 is limited access or when certification: No
Provider ID: 268905 accessibility indicators are not Accepting New Members: Yes
License: PT294386 present. Hours: M-SA 9AM-5PM
Credentials and/or board PTA: No
certification: No 91913 Other Language: Spanish
Accepting New Members: Yes Cultural Competency: NR
Hours: M-SA 9AM-5PM Dagostino, Jacqueline PT Accessibility: B; Members
PTA: No 1392 E Palomar St Ste 503 should call the provider’s
Cultural Competency: NR Chula Vista, CA 91913 office to discuss their
Accessibility: B; Members (619) 482-3000 accessibility needs when there
should call the provider’s Provider ID: 243632 is limited access or when
office to discuss their License: PT295756 accessibility indicators are not
accessibility needs when there Credentials and/or board present.
is limited access or when certification: No
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM Sheffield, Tiffany PT
PTA: No 1392 E Palomar St Ste 503
Cultural Competency: NR Chula Vista, CA 91913
Rydinski, Miles PT Accessibility: B; Members (619) 482-3000
1020 Tierra Del Rey Ste A1 should call the provider’s Provider ID: 255402
Chula Vista, CA 91910 office to discuss their License: PT296953
(619) 585-7104 accessibility needs when there Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 246
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sparks, Todd PT
1392 E Palomar St Ste 503
Chula Vista, CA 91913
(619) 482-3000
Provider ID: 129142
License: PT30298
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
EL CAJON
92021
Miller, Richard PT
1625 E Main St Ste 100
El Cajon, CA 92021
(619) 376-1082
Provider ID: 269763
License: PT22474
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Santiago, Alicia PT
1625 E Main St Ste 104
El Cajon, CA 92021
(619) 873-2160
Provider ID: 269688
License: PT292418
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ENCINITAS
92024
Simmons, Jesse PT
201 S El Camino Real Ste A
Encinitas, CA 92024
(760) 274-1671
Provider ID: 269336
License: PT40517
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 247
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Simmons, Thomas RPT
201 S El Camino Real Ste A
Encinitas, CA 92024
(760) 274-1671
Provider ID: 269272
License: PT11587
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Cullison, Kaleb PT
255 N Elm St Ste 202
Escondido, CA 92025
(760) 504-0223
Provider ID: 269216
License: PT38863
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Tully, Michael PT
255 N Elm St Ste 202
Escondido, CA 92025
(760) 504-0223
Provider ID: 269232
License: PT293675
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92027
Mcgee, Jacqueline PT
1815 E Valley Pkwy Ste 5
Escondido, CA 92027
(760) 434-6100
Provider ID: 252473
License: PT294790
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Meister, Sarah PT
1815 E Valley Pkwy Ste 5
Escondido, CA 92027
(760) 434-6100
Provider ID: 269213
License: PT291898
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 248
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Parker, Cory PT
1815 E Valley Pkwy Ste 5
Escondido, CA 92027
(760) 434-6100
Provider ID: 269227
License: PT296440
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
FALLBROOK
92028
Dolojan, Raphael PT
521 E Elder St Ste 106
Fallbrook, CA 92028
(760) 723-8337
Provider ID: 269186
License: PT42764
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Kaplan, Christopher PT
521 E Elder St Ste 106
Fallbrook, CA 92028
(760) 723-8337
Provider ID: 269187
License: PT292488
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Tully, Michael PT
521 E Elder St Ste 106
Fallbrook, CA 92028
(760) 723-8337
Provider ID: 269233
License: PT293675
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
IMPERIAL BEACH
91932
Sheffield, Tiffany PT
600 Palm Ave Ste 126
Imperial Beach, CA 91932
(619) 482-3000
Provider ID: 255403
License: PT296953
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 249
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Credentials and/or board accessibility indicators are not certification: No
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Diep, Huy PT
1626 Sweetwater Rd Ste A & B
National City, CA 91950
(619) 474-5916
Provider ID: 269130
License: PT294143
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
present.
Foley, Hanna PT
1626 Sweetwater Rd Ste A&b
National City, CA 91950
(619) 474-5916
Provider ID: 269163
License: PT291095
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
OCEANSIDE
92054
Lee, Michael PT
2335 Vista Way
Oceanside, CA 92054
(855) 344-5870
Provider ID: 269372
License: PT43323
Credentials and/or board
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rheaume, Alexander PT
2335 Vista Way
Oceanside, CA 92054
(760) 547-2666
Provider ID: 269461
License: PT39516
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 250
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Hours: M-SA 9AM-5PM92056 92065
Andrew, Meagan PT
3142 Vista Way Ste 101
Oceanside, CA 92056
(951) 696-9353
Provider ID: 269373
License: PT291748
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Blackburn, Gary PT
15525 Pomerado Rd Ste D4
Poway, CA 92064
(858) 674-1600
Provider ID: 269448
License: PT28897
Credentials and/or board
certification: No
Accepting New Members: Yes
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Chan, Oriana PT
15525 Pomerado Rd Ste D4
Poway, CA 92064
(858) 674-1600
Provider ID: 129858
License: PT293406
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
RAMONA
Pfeifer, Janaya PT
850 Main St Ste 105
Ramona, CA 92065
(760) 789-1424
Provider ID: 269584
License: PT292928
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92101
Delasantos, Cameron PT
295 G St
San Diego, CA 92101
(619) 238-4318
Provider ID: 269849
License: PT293413
Credentials and/or board
certification: No
Accepting New Members: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 251
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Hours: M-SA 9AM-5PM Hours: M-SA 9AM-5PM
PTA: No Shah, Zalak PT PTA: No
Cultural Competency: NR 295 G St Cultural Competency: NR
Accessibility: B; Members San Diego, CA 92101 Accessibility: B; Members
should call the provider’s (619) 238-4318 should call the provider’s
office to discuss their Provider ID: 269676 office to discuss their
accessibility needs when there License: PT296627 accessibility needs when there
is limited access or when Credentials and/or board is limited access or when
accessibility indicators are not certification: No accessibility indicators are not
present. Accepting New Members: Yes present.
Hours: M-SA 9AM-5PM
PTA: No
Lloyd, Christopher PT Other Language: Gujarati, Heim, Jessica PT
295 G St Hindi 3760 Convoy St Ste 100
San Diego, CA 92101 Cultural Competency: NR San Diego, CA 92111
(888) 208-8526 Accessibility: B; Members (858) 573-9368
Provider ID: 271014 should call the provider’s Provider ID: 269760
License: PT43591 office to discuss their License: PT294241
Credentials and/or board accessibility needs when there Credentials and/or board
certification: No is limited access or when certification: No
Accepting New Members: Yes accessibility indicators are not Accepting New Members: Yes
Hours: M-SA 9AM-5PM present. Hours: M-SA 9AM-5PM
PTA: No PTA: No
Other Language: Arabic, 92111 Cultural Competency: NR
Portuguese, Spanish Accessibility: B; Members
Cultural Competency: NR Becherer, Kelley PT should call the provider’s
Accessibility: B; Members 3760 Convoy St Ste 101 office to discuss their
should call the provider’s San Diego, CA 92111 accessibility needs when there
office to discuss their (855) 543-0333 is limited access or when
accessibility needs when there Provider ID: 270969 accessibility indicators are not
is limited access or when License: PT43240 present.
accessibility indicators are not Credentials and/or board
present. certification: No
Accepting New Members: Yes Pogasic, Seth PT
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 252
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
3760 Convoy St Ste 101 office to discuss their License: PT9919
San Diego, CA 92111 accessibility needs when there Credentials and/or board
(858) 537-9368 is limited access or when certification: No
Provider ID: 269675 accessibility indicators are not Accepting New Members: Yes
License: PT294961 present. Hours: M-SA 9AM-5PM
Credentials and/or board PTA: No
certification: No Cultural Competency: NR
Accepting New Members: Yes Zafuta, Alyssa PT Accessibility: B; Members
Hours: M-SA 9AM-5PM 3760 Convoy St Ste 100 should call the provider’s
PTA: No San Diego, CA 92111 office to discuss their
Cultural Competency: NR (858) 573-9368 accessibility needs when there
Accessibility: B; Members Provider ID: 269726 is limited access or when
should call the provider’s License: PT292370 accessibility indicators are not
office to discuss their Credentials and/or board present.
accessibility needs when there certification: No
is limited access or when Accepting New Members: Yes 92131 accessibility indicators are not Hours: M-SA 9AM-5PM
present. PTA: No Jung, Calvin PT
Cultural Competency: NR 9909 Mira Mesa Blvd Ste 120
Accessibility: B; Members San Diego, CA 92131
Strem, Brendan PT should call the provider’s (858) 693-0436
3760 Convoy St Ste 100 office to discuss their Provider ID: 271605
San Diego, CA 92111 accessibility needs when there License: PT42181
(858) 573-9368 is limited access or when Credentials and/or board
Provider ID: 271424 accessibility indicators are not certification: No
License: PT38107 present. Accepting New Members: Yes
Credentials and/or board Hours: M-SA 9AM-5PM
certification: No 92121 PTA: No
Accepting New Members: Yes Other Language: Spanish
Hours: M-SA 9AM-5PM Harrah, William RPT Cultural Competency: NR
PTA: No 9333 Genesee Ave Ste 350b Accessibility: B; Members
Cultural Competency: NR San Diego, CA 92121 should call the provider’s
Accessibility: B; Members (858) 455-8584 office to discuss their
should call the provider’s Provider ID: 269689 accessibility needs when there
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 253
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
is limited access or when
accessibility indicators are not
present.
Kamph, Alexandra PT
9909 Mira Mesa Blvd Ste 120
San Diego, CA 92131
(619) 448-4860
Provider ID: 271606
License: PT41577
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Thomason, Erica PT
9909 Mira Mesa Blvd
San Diego, CA 92131
(619) 448-4860
Provider ID: 271593
License: PT296321
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92154
Owens, Jadriane PT
585 Saturn Blvd Ste A
San Diego, CA 92154
(619) 591-1190
Provider ID: 269738
License: PT292222
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN MARCOS
92069
Duong, Andrew PT
2115 Montiel Rd Ste 103
San Marcos, CA 92069
(760) 839-2905
Provider ID: 269953
License: PT40674
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hernandez, Rogelio PT
2115 Montiel Rd Ste 103
San Marcos, CA 92069
(760) 839-2905
Provider ID: 270424
License: PT39405
Credentials and/or board
certification: No
Accepting New Members: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 254
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Hours: M-SA 9AM-5PM Kurtz, Benjamin PT Accessibility: B; Members
PTA: No 277 Rancheros Dr Ste 150 should call the provider’s
Other Language: Spanish San Marcos, CA 92069 office to discuss their
Cultural Competency: NR (951) 696-9353 accessibility needs when there
Accessibility: B; Members Provider ID: 270332 is limited access or when
should call the provider’s License: PT291545 accessibility indicators are not
office to discuss their Credentials and/or board present.
accessibility needs when there certification: No
is limited access or when Accepting New Members: Yes
accessibility indicators are not Hours: M-SA 9AM-5PM Mallinson, Darren PT
present. PTA: No 2115 Montiel Rd Ste 103
Cultural Competency: NR San Marcos, CA 92069
Accessibility: B; Members (760) 839-2905
Jimenez, Monica PT should call the provider’s Provider ID: 271147
2115 Montiel Rd Ste 103 office to discuss their License: PT28994
San Marcos, CA 92069 accessibility needs when there Credentials and/or board
(760) 839-2905 is limited access or when certification: No
Provider ID: 269773 accessibility indicators are not Accepting New Members: Yes
License: PT33505 present. Hours: M-SA 9AM-5PM
Credentials and/or board PTA: No
certification: No Cultural Competency: NR
Accepting New Members: Yes Lane, Jennifer PT Accessibility: B; Members
Hours: M-SA 9AM-5PM 2115 Montiel Rd # 200 should call the provider’s
PTA: No San Marcos, CA 92069 office to discuss their
Cultural Competency: NR (760) 839-2905 accessibility needs when there
Accessibility: B; Members Provider ID: 270663 is limited access or when
should call the provider’s License: PT37920 accessibility indicators are not
office to discuss their Credentials and/or board present.
accessibility needs when there certification: No
is limited access or when Accepting New Members: Yes
accessibility indicators are not Hours: M-SA 9AM-5PM Shannon, Michael PT
present. PTA: No 2115 Montiel Rd Ste 103
Other Language: Spanish San Marcos, CA 92069
Cultural Competency: NR (760) 839-2905
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 255
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Provider ID: 269581
License: PT27069
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Shao, Paula PT
2115 Montiel Rd Ste 103
San Marcos, CA 92069
(760) 839-2905
Provider ID: 269785
License: PT19297
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Spurrell, Kathryn PT
2115 Montiel Rd Ste 103
San Marcos, CA 92069
(760) 839-2905
Provider ID: 269602
License: PT40706
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Yap, Amanda PT
2115 Montiel Rd Ste 103
San Marcos, CA 92069
(760) 839-2905
Provider ID: 270649
License: PT292801
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Chinese,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SANTEE
92071
Boutelle, David RPT
9830 Prospect Ave Ste A
Santee, CA 92071
(619) 448-4860
Provider ID: 248308
License: PT12422
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 256
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
present.
Daher, Nicole PT
9830 Prospect Ave Ste A
Santee, CA 92071
(619) 448-4860
Provider ID: 270343
License: PT42881
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dansey, Ashley PT
9830 Prospect Ave Ste A
Santee, CA 92071
(619) 448-4860
Provider ID: 270339
License: PT36952
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Grieger, Nancy PT
8790 Cuyamaca St Ste A
Santee, CA 92071
(619) 596-5969
Provider ID: 270118
License: PT40167
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Miller, Laura PT
8790 Cuyamaca St Ste A
Santee, CA 92071
(619) 596-5969
Provider ID: 271143
License: PT26121
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Monroe, Max PT
8790 Cuyamaca St Ste A
Santee, CA 92071
(619) 596-5969
Provider ID: 269925
License: PT294368
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 257
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rouillard, Norma PT
8790 Cuyamaca St Ste A
Santee, CA 92071
(619) 596-5969
Provider ID: 269600
License: PT29262
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
VISTA
92083
Ambrose, Christopher PT
2067 W Vista Way Ste 185
Vista, CA 92083
(760) 631-5888
Provider ID: 248009
License: PT26311
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Smith, Dennis PT
2067 W Vista Way Ste 185
Vista, CA 92083
(760) 631-5888
Provider ID: 247478
License: PT22171
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rheumatology
CHULA VISTA
91910
Kotha, Akther MD
374 H St Ste 103
Chula Vista, CA 91910
(619) 205-0120
Provider ID: 53697
License: A45440
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Hindi, Spanish, Telugu, Urdu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
91911
Chitkara, Puja MD
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 258
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
765 Medical Center Ct Ste 216
Chula Vista, CA 91911
(619) 623-3000
Provider ID: 204158
License: A97619
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Hindi,
Russian, Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Chwa, Jeffrey DO
765 Medical Center Ct Ste 216
Chula Vista, CA 91911
(619) 623-3000
Provider ID: 268780
License: 20A14736
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Pazirandeh, Mahmood MD
1310 3rd Ave Ste B3
Chula Vista, CA 91911
(619) 827-0276
Provider ID: 268796
License: C52328
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Farsi,
Russian, Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Rao, Soumya MD
488 E Valley Pkwy Ste 211
Escondido, CA 92025
(858) 675-3150
Provider ID: 269101
License: A99911
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Hindi,
Kannada, Russian, Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Kotha, Akther MD
8860 Center Dr Ste 400
La Mesa, CA 91942
(619) 229-1995
Provider ID: 29099
License: A45440
Credentials and/or board
certification: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 259
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic,
Hindi, Spanish, Telugu, Urdu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Kotha, Roshan MD
8860 Center Dr Ste 400
La Mesa, CA 91942
(619) 229-1995
Provider ID: 63454
License: A106044
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Hindi,
Spanish, Telugu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Chitkara, Puja MD
502 Euclid Ave Ste 300
National City, CA 91950
(619) 623-3000
Provider ID: 204159
License: A97619
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Hindi,
Russian, Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Rao, Soumya MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3150
Provider ID: 46060
License: A99911
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Hindi,
Kannada, Russian, Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Reddy, Smitha MD
15725 Pomerado Rd Ste 117
Poway, CA 92064
(858) 312-1717
Provider ID: 269402
License: A85072
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 260
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Other Language: Hindi,
Kannada, Telugu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92108
Pazirandeh, Mahmood MD
3633 Camino Del Rio S Ste 300
San Diego, CA 92108
(619) 287-9730
Provider ID: 209535
License: C52328
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Russian, Spanish, Tagalog
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Surgery Cardiovascular
ESCONDIDO
92029
Lin, Yuan MD
1955 Citracado Pkwy Ste 300
Escondido, CA 92029
(760) 743-0546
Provider ID: 241290
License: A43050
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Cantonese,
Mandarin, Yue Chinese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Surgery Colon Surgery
SAN DIEGO
92103
Isho, Mathew MD
4060 4th Ave Ste 510
San Diego, CA 92103
(619) 686-4011
Provider ID: 245185
License: A93470
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Surgery General Vascular
CHULA VISTA
91911
Salloum, Alexander MD
1111 Broadway Ste 305
Chula Vista, CA 91911
(619) 567-7007
Provider ID: 268764
License: A89300
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 261
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Bulkin, Anatoly MD
625 Citracado Pkwy Ste 203
Escondido, CA 92025
(760) 739-7666
Provider ID: 51838
License: G79826
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Russian,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Chang, Alexander MD
625 Citracado Pkwy Ste 203
Escondido, CA 92025
(760) 739-7666
Provider ID: 75855
License: A123245
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Korean
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Nemceff, Dennis MD
625 Citracado Pkwy Ste 203
Escondido, CA 92025
(760) 739-7666
Provider ID: 246553
License: A123910
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Russian
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92115
Salloum, Alexander MD
6402 El Cajon Blvd Ste 100 &
102
San Diego, CA 92115
(619) 582-4490
Provider ID: 268765
License: A89300
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 262
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Surgery General
CHULA VISTA
91910
Hsu, Andrew MD
480 4th Ave Ste 404
Chula Vista, CA 91910
(619) 425-4559
Provider ID: 53785
License: A108956
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Mandarin,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hsu, Bradford MD
480 4th Ave Ste 404
Chula Vista, CA 91910
(619) 425-4559
Provider ID: 53792
License: A86179
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Yu, Nicholas MD
480 4th Ave Ste 404
Chula Vista, CA 91910
(619) 425-5184
Provider ID: 100762
License: A136120
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Korean,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92029
Grove, Jay MD
2185 Citracado Pkwy
Escondido, CA 92029
(760) 300-3647
Provider ID: 245226
License: A60426
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 263
221
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
LA MESA
91942
Dickinson, Phillip MD
8554 La Mesa Blvd
La Mesa, CA 91942
(619) 464-4469
Provider ID: 269694
License: A86720
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Lin, Hong-der MD
5565 Grossmont Center Dr Ste
La Mesa, CA 91942
(619) 462-8100
Provider ID: 268968
License: C42964
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Chinese,
Japanese, Mandarin, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Lavotshkin, Simon MD
5565 Grossmont Center Dr Ste
221 Bldg 1
La Mesa, CA 91942
(619) 462-8100
Provider ID: 268988
License: A125514
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Chinese,
Hebrew, Korean, Russian,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Orr, Carl MD
5565 Grossmont Center Dr Ste
221
La Mesa, CA 91942
(619) 462-8100
Provider ID: 26549
License: G58899
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sohn, Helen MD
5565 Grossmont Center Dr Ste
221
La Mesa, CA 91942
(619) 462-8100
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 264
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Provider ID: 268903
License: A87722
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92103
Kurtzhals, Pamela MD
3366 5th Ave
San Diego, CA 92103
(619) 550-1500
Provider ID: 269976
License: A75524
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there Credentials and/or board
is limited access or when certification: Yes
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM
PTA: No
92123 Cultural Competency: NR
Accessibility: B; Members
Bench, Gary MD should call the provider’s
7910 Frost St Ste 250 office to discuss their
San Diego, CA 92123 accessibility needs when there
(858) 565-0104 is limited access or when
Provider ID: 269682 accessibility indicators are not
License: A35873 present.
Credentials and/or board
certification: No
Accepting New Members: Yes Brown, Kristian MD
Hours: M-SA 9AM-5PM 8010 Frost St Ste 510
PTA: No San Diego, CA 92123
Cultural Competency: NR (858) 637-4800
Accessibility: B; Members Provider ID: 97599
should call the provider’s License: A124291
office to discuss their Credentials and/or board
accessibility needs when there certification: No
is limited access or when Accepting New Members: Yes
accessibility indicators are not Hours: M-SA 9AM-5PM
present. PTA: No
Cultural Competency: NR
Accessibility: B; Members
Bench, Shawn MD should call the provider’s
7910 Frost St Ste 250 office to discuss their
San Diego, CA 92123 accessibility needs when there
(858) 565-0104 is limited access or when
Provider ID: 129060 accessibility indicators are not
License: A108975 present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 265
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Other Language: Spanish, 8010 Frost St Ste 510
Tagalog San Diego, CA 92123
Barnes, Ryan DO Cultural Competency: NR (858) 499-1900
7910 Frost St Ste 250 Accessibility: B; Members Provider ID: 82513
San Diego, CA 92123 should call the provider’s License: A60375
(858) 565-0104 office to discuss their Credentials and/or board
Provider ID: 129062 accessibility needs when there certification: No
License: 20A12870 is limited access or when Accepting New Members: Yes
Credentials and/or board accessibility indicators are not Hours: M-SA 9AM-5PM
certification: No present. PTA: No
Accepting New Members: Yes Other Language: Spanish
Hours: M-SA 9AM-5PM Cultural Competency: NR
PTA: No Hart, Marquis MD Accessibility: B; Members
Cultural Competency: NR 8010 Frost St Ste 510 should call the provider’s
Accessibility: B; Members San Diego, CA 92123 office to discuss their
should call the provider’s (858) 637-4800 accessibility needs when there
office to discuss their Provider ID: 279694 is limited access or when
accessibility needs when there License: A42694 accessibility indicators are not
is limited access or when Credentials and/or board present.
accessibility indicators are not certification: No
present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM Mueller, George MD
PTA: No 7910 Frost St Ste 250
Halldorson, Jeffrey MD Cultural Competency: NR San Diego, CA 92123
8010 Frost St Ste 510 Accessibility: B; Members (858) 565-0104
San Diego, CA 92123 should call the provider’s Provider ID: 54298
(858) 637-4800 office to discuss their License: A41127
Provider ID: 270147 accessibility needs when there Credentials and/or board
License: G86089 is limited access or when certification: Yes
Credentials and/or board accessibility indicators are not Accepting New Members: Yes
certification: No present. Hours: M-SA 9AM-5PM
Accepting New Members: Yes PTA: No
Hours: M-SA 9AM-5PM Other Language: Spanish,
PTA: No Kosoy, Daniel MD Vietnamese
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 266
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Pollack, Larry MD
7910 Frost St Ste 250
San Diego, CA 92123
(858) 565-0104
Provider ID: 54346
License: A41696
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: German,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Woodward, Stephanie MD
7910 Frost St Ste 250
San Diego, CA 92123
(858) 565-0104
Provider ID: 63697
License: A103828
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
VISTA
92081
Fierer, Adam MD
2385 S Melrose Dr
Vista, CA 92081
(760) 300-3647
Provider ID: 86667
License: G69685
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Grove, Jay MD
2385 S Melrose Dr
Vista, CA 92081
(760) 300-3647
Provider ID: 245227
License: A60426
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hanna, Karen MD
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 267
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
2385 S Melrose Dr
Vista, CA 92081
(760) 300-3647
Provider ID: 246422
License: G88851
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Surgery Hand
ESCONDIDO
92029
Patel, Arush MD
1955 Citracado Pkwy Ste 200
Escondido, CA 92029
(760) 743-4789
Provider ID: 77773
License: A105982
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Surgery Neurological
ENCINITAS
92024
Yoo, Frank MD
477 N El Camino Real Ste D200
Encinitas, CA 92024
(760) 452-3340
Provider ID: 257374
License: G86513
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Korean,
Spanish, Telugu, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Stern, Mark MD
705 E Ohio Ave
Escondido, CA 92025
(760) 489-9490
Provider ID: 243486
License: G47596
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Yoo, Frank MD
9850 Genesee Ave Ste 560
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 268
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
La Jolla, CA 92037
(858) 909-9033
Provider ID: 248120
License: G86513
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Korean,
Spanish, Telugu, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Yoo, Frank MD
2345 E 8th St Ste 110
National City, CA 91950
(858) 909-9033
Provider ID: 257372
License: G86513
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Korean,
Spanish, Telugu, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
OCEANSIDE
92056
Yoo, Frank MD
3998 Vista Way Ste 108
Oceanside, CA 92056
(858) 909-9033
Provider ID: 257373
License: G86513
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Korean,
Spanish, Telugu, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92123
Soumekh, Massoud Hertzel MD
8008 Frost St Ste 401
San Diego, CA 92123
(858) 560-8544
Provider ID: 54178
License: A37843
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Surgery Orthopedic
CHULA VISTA
91910
Bagheri, Ali MD
480 Fourth Ave Ste 501
Chula Vista, CA 91910
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 269
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
(619) 425-9510 should call the provider’s Provider ID: 242939
Provider ID: 117911 office to discuss their License: G75293
License: A123272 accessibility needs when there Credentials and/or board
Credentials and/or board is limited access or when certification: No
certification: No accessibility indicators are not Accepting New Members: Yes
Accepting New Members: Yes present. Hours: M-SA 9AM-5PM
Hours: M-SA 9AM-5PM PTA: No
PTA: No Other Language: Spanish
Other Language: Farsi, Rosenfield, Alan MD Cultural Competency: NR
Spanish 480 4th Ave Ste 501 Accessibility: B; Members
Cultural Competency: NR Chula Vista, CA 91910 should call the provider’s
Accessibility: B; Members (619) 425-9510 office to discuss their
should call the provider’s Provider ID: 242937 accessibility needs when there
office to discuss their License: G75293 is limited access or when
accessibility needs when there Credentials and/or board accessibility indicators are not
is limited access or when certification: Yes present.
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM
PTA: Yes Tayyab, Neil MD
Other Language: Spanish 480 4th Ave Ste 501
Kimball, Michael MD Cultural Competency: NR Chula Vista, CA 91910
480 4th Ave Ste 501 Accessibility: B; Members (619) 425-9510
Chula Vista, CA 91910 should call the provider’s Provider ID: 268616
(858) 455-6460 office to discuss their License: A94408
Provider ID: 268619 accessibility needs when there Credentials and/or board
License: G76060 is limited access or when certification: No
Credentials and/or board accessibility indicators are not Accepting New Members: Yes
certification: Yes present. Hours: M-SA 9AM-5PM
Accepting New Members: Yes PTA: Yes
Hours: M-SA 9AM-5PM Cultural Competency: NR
PTA: Yes Rosenfield, Alan MD Accessibility: B; Members
Other Language: Spanish 480 Fourth Ave Ste 509 should call the provider’s
Cultural Competency: NR Chula Vista, CA 91910 office to discuss their
Accessibility: B; Members (619) 425-9510 accessibility needs when there
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 270
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Kimball, Michael MD
457 N Elm St
Escondido, CA 92025
(858) 455-6460
Provider ID: 122878
License: G76060
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92029
Barba, Daniel MD
1955 Citracado Pkwy Ste 200
Escondido, CA 92029
(760) 743-4789
Provider ID: 77895
License: A119351
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Knutson, Thomas MD
1955 Citracado Pkwy Ste 200
Escondido, CA 92029
(760) 743-4789
Provider ID: 31099
License: G50268
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Owsley, Kevin MD
1955 Citracado Pkwy Ste 200
Escondido, CA 92029
(760) 743-4789
Provider ID: 269326
License: A98739
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sharp, Lorra MD
1955 Citracado Pkwy Ste 200
Escondido, CA 92029
(760) 743-4789
Provider ID: 243552
License: A117353
Credentials and/or board
certification: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 271
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Accepting New Members: Yes accessibility indicators are not certification: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Allsing, Steven MD
5565 Grossmont Center Dr Ste
112 Bldg 1
La Mesa, CA 91942
(619) 465-0083
Provider ID: 211762
License: G84903
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Bagheri, Ali MD Other Language: Spanish
8851 Center Dr Ste 601 Cultural Competency: NR
La Mesa, CA 91942 Accessibility: B; Members
(619) 441-9811 should call the provider’s
Provider ID: 125035 office to discuss their
License: A123272 accessibility needs when there
Credentials and/or board is limited access or when
certification: No accessibility indicators are not
Accepting New Members: Yes present.
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi, Rickards, Enass MD
Spanish 8851 Center Dr Ste 601
Cultural Competency: NR La Mesa, CA 91942
Accessibility: B; Members (858) 455-6460
should call the provider’s Provider ID: 268907
office to discuss their License: G79785
accessibility needs when there Credentials and/or board
is limited access or when certification: No
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic
Kimball, Michael MD Cultural Competency: NR
8851 Center Dr Ste 601 Accessibility: B; Members
La Mesa, CA 91942 should call the provider’s
(858) 455-6460 office to discuss their
Provider ID: 44005 accessibility needs when there
License: G76060 is limited access or when
Credentials and/or board accessibility indicators are not
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 272
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
present.
Rosenfield, Alan MD
8851 Center Dr Ste 601
La Mesa, CA 91942
(858) 455-6460
Provider ID: 242936
License: G75293
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Balikian, Philip MD
15611 Pomerado Rd Ste 400
Poway, CA 92064
(858) 675-3286
Provider ID: 119552
License: C52136
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Armenian,
Italian, Spanish, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Bried, James MD
15611 Pomerado Rd Ste 525
Poway, CA 92064
(858) 485-0050
Provider ID: 269500
License: G62595
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Cohen, Brad MD
15611 Pomerado Rd Ste 525
Poway, CA 92064
(858) 485-0050
Provider ID: 269449
License: A62550
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Owsley, Kevin MD
15611 Pomerado Rd Ste 525
Poway, CA 92064
(858) 485-0050
Provider ID: 269325
License: A98739
Credentials and/or board
certification: No
Accepting New Members: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 273
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Palanca, Ariel MD
15611 Pomerado Rd Ste 525
Poway, CA 92064
(858) 485-0050
Provider ID: 269861
License: A114257
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92120
Alfieri, Keith MD
6719 Alvarado Rd Ste 200
San Diego, CA 92120
(619) 229-5018
Provider ID: 273888
License: C161523
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Burnikel, David MD
6719 Alvarado Rd Ste 200
San Diego, CA 92120
(619) 229-3932
Provider ID: 205079
License: A138043
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Klatman, Samuel MD
6719 Alvarado Rd Ste 200
San Diego, CA 92120
(619) 229-5018
Provider ID: 275652
License: A166831
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Page, Alexandra MD
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 274
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
6719 Alvarado Rd Ste 200 should call the provider’s Provider ID: 218096
San Diego, CA 92120 office to discuss their License: G14672
(619) 229-3932 accessibility needs when there Credentials and/or board
Provider ID: 109720 is limited access or when certification: Yes
License: G84448 accessibility indicators are not Accepting New Members: Yes
Credentials and/or board present. Hours: M-SA 9AM-5PM
certification: No PTA: Yes
Accepting New Members: Yes Cultural Competency: NR
Hours: M-SA 9AM-5PM Shillito, Matthew MD Accessibility: B; Members
PTA: No 6719 Alvarado Rd Ste 200 should call the provider’s
Cultural Competency: NR San Diego, CA 92120 office to discuss their
Accessibility: B; Members (619) 229-3932 accessibility needs when there
should call the provider’s Provider ID: 247893 is limited access or when
office to discuss their License: A109569 accessibility indicators are not
accessibility needs when there Credentials and/or board present.
is limited access or when certification: No
accessibility indicators are not Accepting New Members: Yes 92121 present. Hours: M-SA 9AM-5PM
PTA: No Bagheri, Ali MD
Other Language: Spanish 9333 Genesee Ave Ste 350a
Sirota, Michael MD Cultural Competency: NR San Diego, CA 92121
6719 Alvarado Rd Ste 200 Accessibility: B; Members (858) 455-6460
San Diego, CA 92120 should call the provider’s Provider ID: 117900
(619) 229-3932 office to discuss their License: A123272
Provider ID: 84579 accessibility needs when there Credentials and/or board
License: A129445 is limited access or when certification: No
Credentials and/or board accessibility indicators are not Accepting New Members: Yes
certification: No present. Hours: M-SA 9AM-5PM
Accepting New Members: Yes PTA: No
Hours: M-SA 9AM-5PM Other Language: Farsi,
PTA: Yes Tasto, James MD Spanish
Other Language: Spanish 6719 Alvarado Rd Ste 200 Cultural Competency: NR
Cultural Competency: NR San Diego, CA 92120 Accessibility: B; Members
Accessibility: B, W; Members (619) 229-3932 should call the provider’s
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 275
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Kimball, Michael MD
9333 Genesee Ave Ste 350
San Diego, CA 92121
(858) 455-6460
Provider ID: 38205
License: G76060
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rickards, Enass MD
9333 Genesee Ave Ste 350
San Diego, CA 92121
(858) 455-6460
Provider ID: 268909
License: G79785
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rosenfield, Alan MD
9333 Genesee Ave Ste 350
San Diego, CA 92121
(858) 455-6460
Provider ID: 242938
License: G75293
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Tayyab, Neil MD
9333 Genesee Ave Ste 350a
San Diego, CA 92121
(858) 455-6460
Provider ID: 268617
License: A94408
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Urology
ENCINITAS
92024
Butler, Philip MD
320 Santa Fe Dr Ste 305
Encinitas, CA 92024
(760) 436-4558
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 276
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Provider ID: 269433
License: G47129
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Cohen, Edward MD
320 Santa Fe Dr Ste 305
Encinitas, CA 92024
(760) 436-4558
Provider ID: 269340
License: G56844
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Juma, Saad MD
320 Santa Fe Dr Ste 108
Encinitas, CA 92024
(760) 753-8373
Provider ID: 244006
License: A42398
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Naitoh, John MD
320 Santa Fe Dr Ste 305
Encinitas, CA 92024
(760) 436-4558
Provider ID: 269477
License: G82079
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92029
Cohen, Edward MD
1955 Citracado Pkwy Ste 302
Escondido, CA 92029
(760) 743-5111
Provider ID: 269341
License: G56844
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 277
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
office to discuss their (858) 453-5944 office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Jones, Thomas MD
1955 Citracado Pkwy Ste 302
Escondido, CA 92029
(760) 743-5111
Provider ID: 75512
License: G51735
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Butler, Philip MD
9850 Genesee Ave Ste 440
La Jolla, CA 92037
Provider ID: 65710
License: G47129
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Cohen, Edward MD
9850 Genesee Ave Ste 440
La Jolla, CA 92037
(858) 453-5944
Provider ID: 65713
License: G56844
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Naitoh, John MD
9850 Genesee Ave Ste 440
La Jolla, CA 92037
(858) 453-5944
Provider ID: 55260
License: G82079
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Nguyen, Hung MD
9850 Genesee Ave Ste 440
La Jolla, CA 92037
(858) 453-5944
Provider ID: 246842
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 278
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
License: A142209
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Dato, Paul MD
8851 Center Dr Ste 501
La Mesa, CA 91942
(619) 697-2456
Provider ID: 112527
License: A43540
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Kearse, Wilfred MD
8851 Center Dr Ste 501
La Mesa, CA 91942
(619) 697-2456
Provider ID: 268850
License: G83318
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Siegel, Jordan MD
8851 Center Dr Ste 501
La Mesa, CA 91942
(619) 697-2456
Provider ID: 101015
License: A110507
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Salmasi, Amirali MD
8851 Center Dr Ste 501
La Mesa, CA 91942
(619) 697-2456
Provider ID: 129643
License: A135118
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 279
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
accessibility indicators are not
present.
Tanagho, Youssef MD
8851 Center Dr Ste 501
La Mesa, CA 91942
(619) 697-2456
Provider ID: 124747
License: A125924
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
French
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Dicks, Brian MD
12630 Monte Vista Rd Ste 103
Poway, CA 92064
(858) 451-1772
Provider ID: 270141
License: A100413
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Neustein, Paul MD
15644 Pomerado Rd Ste 206
Poway, CA 92064
(858) 485-0554
Provider ID: 42034
License: G42225
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Hebrew,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Pe, Mark- Rally MD
12630 Monte Vista Rd Ste 103
Poway, CA 92064
(858) 451-1772
Provider ID: 269348
License: A112013
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92103
Dicks, Brian MD
4060 4th Ave Ste 310
San Diego, CA 92103
(619) 297-4707
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 280
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
Provider ID: 57668 is limited access or when certification: Yes
License: A100413
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Holden, Marc MD
4060 4th Ave Ste 310
San Diego, CA 92103
(619) 297-4707
Provider ID: 269620
License: A129770
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
accessibility indicators are not
present.
Pe, Mark- Rally MD
4060 4th Ave Ste 310
San Diego, CA 92103
(619) 297-4707
Provider ID: 55252
License: A112013
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Roberts, James MD
4033 3rd Ave Ste 400
San Diego, CA 92103
(619) 299-0670
Provider ID: 65495
License: G59945
Credentials and/or board
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Salem, Carol MD
4060 4th Ave Ste 310
San Diego, CA 92103
(619) 297-4707
Provider ID: 56016
License: G75788
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 281
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
present. Accepting New Members: Yes
Vapnek, Evan MD
4033 3rd Ave Ste 400
San Diego, CA 92103
(619) 299-0670
Provider ID: 65497
License: G75357
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92123
Dato, Paul MD
3444 Kearny Villa Rd Ste 201
San Diego, CA 92123
(858) 430-1101
Provider ID: 269141
License: A43540
Credentials and/or board
certification: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Gaylis, Franklin MD
5395 Ruffin Rd Ste 202
San Diego, CA 92123
(858) 569-7800
Provider ID: 119549
License: A46251
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Keiller, Danny MD
3444 Kearny Villa Rd Ste 202
San Diego, CA 92123
(619) 299-0670
Provider ID: 243958
License: C32092
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Roberts, James MD
3444 Kearny Villa Rd Ste 201
San Diego, CA 92123
(858) 430-1101
Provider ID: 270010
License: G59945
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 282
SAN DIEGO COUNTY MEDICAL GROUPS COMMUNITY CARE IPA LLC
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Vapnek, Evan MD
3444 Kearny Villa Rd Ste 201
San Diego, CA 92123
(858) 430-1101
Provider ID: 270006
License: G75357
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 283
SAN DIEGO COUNTY MEDICAL GROUPS GREATER TRI CITIES IPA MEDICAL GROUP INC
AFFILIATED HOSPITALS
Above are hospitals you may
visit through this Medical
Group. For a complete listing
of hospital affiliations or to
access another hospital, refer
to page 1319. You will need to
coordinate with your PCP
and/or Medical Group. For
questions, call Blue Shield
Promise Cal MediConnect
Plan Customer Care.
PRIMARY CARE PHYSICIANS
Family Practice
CARLSBAD
92008
Ajir, Mahyar DO
2801 Jefferson St
Carlsbad, CA 92008
(760) 729-4952
Provider ID: 55698
License: 20A6683
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Etedali, Elaheh DO
2801 Jefferson St
Carlsbad, CA 92008
(760) 729-4952
Provider ID: 55545
License: 20A6701
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Perez, Ronald MD
1207 Carlsbad Village Dr Ste A
Carlsbad, CA 92008
(760) 896-3030
Provider ID: 215895
License: A132584
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN MARCOS
92078
Halim, Neil MD
1030 La Bonita Dr Ste 316
San Marcos, CA 92078
(760) 744-9626
Provider ID: 54487
License: C53327
Credentials and/or board
certification: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 284
SAN DIEGO COUNTY MEDICAL GROUPS GREATER TRI CITIES IPA MEDICAL GROUP INC
Accepting New Members: Yes is limited access or when certification: No
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
VISTA
92081
Clark, Ma Belen MD
1954 Via Ctr Ste B
Vista, CA 92081
(760) 529-9700
Provider ID: 108704
License: A100202
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
accessibility indicators are not
present.
92083
Falconio, Linda MD
2067 W Vista Way Ste 130
Vista, CA 92083
(760) 631-4000
Provider ID: 92481
License: G37851
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hurd, Melissa MD
161 Thunder Dr Ste 103
Vista, CA 92083
(760) 758-1988
Provider ID: 49432
License: A61672
Credentials and/or board
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92084
Fatland, Sarah DO
1000 Vale Terrace Dr
Vista, CA 92084
(760) 631-5000
Provider ID: 278889
License: 20A18374
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 285
SAN DIEGO COUNTY MEDICAL GROUPS GREATER TRI CITIES IPA MEDICAL GROUP INC
present. License: A52193 office to discuss their
General Practice
ESCONDIDO
92025
Watson, Thomas MD
303 S Juniper St
Escondido, CA 92025
(760) 480-9051
Provider ID: 125694
License: A52193
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Watson, Thomas MD
301 E Washington Ave Ste B
Escondido, CA 92025
(760) 480-9051
Provider ID: 62912
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
VISTA
92083
Oliva, Carlos MD
969 S Santa Fe Ave Ste A
Vista, CA 92083
(760) 941-7050
Provider ID: 129919
License: A40155
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Smith, Gregory MD
161 Thunder Dr Ste 207
Vista, CA 92083
(760) 598-8410
Provider ID: 49457
License: G48979
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Internal Medicine
CARLSBAD
92009
Chong, Maribeth MD
6260 El Camino Real Ste 105
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 286
SAN DIEGO COUNTY MEDICAL GROUPS GREATER TRI CITIES IPA MEDICAL GROUP INC
Carlsbad, CA 92009
(760) 434-6060
Provider ID: 108632
License: C51324
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Chong, Yoo Jin MD
6260 El Camino Real Ste 105
Carlsbad, CA 92009
(760) 434-6060
Provider ID: 108636
License: G86822
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Korean
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
OCEANSIDE
92056
Curran, Perrin MD
3601 Vista Way Ste 201
Oceanside, CA 92056
(760) 945-1894
Provider ID: 49427
License: G83073
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Ibrahim, Nagi MD
3231 Waring Ct Ste K
Oceanside, CA 92056
(760) 630-4499
Provider ID: 123114
License: A75003
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Lawson, Catherine MD
3230 Waring Ct Ste J
Oceanside, CA 92056
(760) 941-4498
Provider ID: 49438
License: G65272
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 287
SAN DIEGO COUNTY MEDICAL GROUPS GREATER TRI CITIES IPA MEDICAL GROUP INC
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92058
Lizotte, Paul DO
115 N El Camino Real Ste A
Oceanside, CA 92058
(760) 330-5055
Provider ID: 276640
License: 20A6147
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
VISTA
92081
Clancy, Tara DO
2375 S Melrose Dr
Vista, CA 92081
(760) 305-1900
Provider ID: 107352
License: 20A9695
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92083
Bloom, Irving MD
130 Cedar Rd # 310
Vista, CA 92083
(760) 630-9095
Provider ID: 49408
License: G32967
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: German,
Japanese
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SPECIALISTS
Members may not self-refer to
any of the specialists listed
below. To receive covered
services from a specialist you
must receive a referral from
your primary care physician.
Cardiology
OCEANSIDE
92056
Rajamanickam, Anitha MD
3907 Waring Rd Ste 3
Oceanside, CA 92056
(760) 224-7766
Provider ID: 270156
License: A137462
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 288
SAN DIEGO COUNTY MEDICAL GROUPS GREATER TRI CITIES IPA MEDICAL GROUP INC
PTA: No
Other Language: Hindi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
VISTA
92083
Bui, Hanh MD
2067 W Vista Way Ste 225
Vista, CA 92083
(760) 630-2550
Provider ID: 109034
License: A79185
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Chinese,
Spanish, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Cardiovascular Disease
OCEANSIDE
92056
Kabra, Ashish MD
3909 Waring Rd Ste A
Oceanside, CA 92056
(760) 630-0255
Provider ID: 122480
License: A122620
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN MARCOS
92078
Moussavian, Mehran DO
955 Boardwalk Ste 100
San Marcos, CA 92078
(619) 616-2100
Provider ID: 129105
License: 20A7241
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dermatology
OCEANSIDE
92056
Angra, Kunal MD
3629 Vista Way
Oceanside, CA 92056
(760) 757-7546
Provider ID: 272503
License: A161745
Credentials and/or board
certification: No
Accepting New Members: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 289
SAN DIEGO COUNTY MEDICAL GROUPS GREATER TRI CITIES IPA MEDICAL GROUP INC
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Gray, Jayla MD
3629 Vista Way
Oceanside, CA 92056
(760) 757-7546
Provider ID: 278763
License: A169832
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hospice and Palliative
Medicine
SAN MARCOS
92069
Pasha, Sabiha MD
838 Nordahl Rd Ste 300
San Marcos, CA 92069
(760) 747-8935
Provider ID: 278960
License: C50413
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: German,
Spanish, Urdu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Nephrology
CARLSBAD
92011
Choudry, Bilal MD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 85292
License: A114607
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Urdu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Wang, Chunyang MD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 84398
License: A105660
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 290
SAN DIEGO COUNTY MEDICAL GROUPS GREATER TRI CITIES IPA MEDICAL GROUP INC
Other Language: Mandarin,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Neurology
Gualberto, Gary MD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 103158
License: C138319
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Oh, Irene MD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 52430
License: A106450
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Pham, Alise DO
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 278296
License: 20A18259
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Obstetrics / Gynecology
OCEANSIDE
92056
Penvose-yi, Jan MD
3998 Vista Way Ste C
Oceanside, CA 92056
(760) 385-8008
Provider ID: 88524
License: C132992
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 291
SAN DIEGO COUNTY MEDICAL GROUPS GREATER TRI CITIES IPA MEDICAL GROUP INC
Suntay, Berk MD
3998 Vista Way Ste C
Oceanside, CA 92056
(760) 941-1440
Provider ID: 278754
License: A124008
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
VISTA
92083
Clarkson, Chunjai MD
145 Thunder Dr
Vista, CA 92083
(760) 941-9002
Provider ID: 247862
License: G73471
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Ebrahimi Adib, Tannaz MD
2067 W Vista Way Ste 160
Vista, CA 92083
(760) 990-7585
Provider ID: 97633
License: A121761
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Persian
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92084
Leon, Josue MD
1000 Vale Terrace Dr
Vista, CA 92084
(760) 631-5000
Provider ID: 278976
License: A80635
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Ophthalmology
ENCINITAS
92024
Johnston, Eric MD
477 N El Camino Real Ste C202
Encinitas, CA 92024
(760) 631-3500
Provider ID: 278613
License: C169344
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 292
SAN DIEGO COUNTY MEDICAL GROUPS GREATER TRI CITIES IPA MEDICAL GROUP INC
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Otolaryngology
OCEANSIDE
92056
Carroll, Sarah MD
3907 Waring Rd Ste 1
Oceanside, CA 92056
(760) 724-8749
Provider ID: 278735
License: A117013
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
VISTA
92083
Kushnaryov, Anton MD
2023 W Vista Way Ste J
Vista, CA 92083
(760) 726-2440
Provider ID: 117871
License: A114550
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Podiatrist
ENCINITAS
92024
Hatfield, James DPM
501 N El Camino Real Ste 201
Encinitas, CA 92024
(760) 436-8667
Provider ID: 99314
License: DPM1834
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Radiation Oncology
SAN DIEGO
92127
Bruggeman, Andrew MD
16918 Dove Canyon Rd Ste
103
San Diego, CA 92127
(858) 649-5100
Provider ID: 276717
License: A126549
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 293
SAN DIEGO COUNTY MEDICAL GROUPS GREATER TRI CITIES IPA MEDICAL GROUP INC
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Surgery General
VISTA
92081
Fierer, Adam MD
2385 S Melrose Dr
Vista, CA 92081
(760) 300-3647
Provider ID: 86667
License: G69685
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Grove, Jay MD
2385 S Melrose Dr
Vista, CA 92081
(760) 300-3647
Provider ID: 53850
License: A60426
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hanna, Karen MD
2385 S Melrose Dr
Vista, CA 92081
(760) 300-3647
Provider ID: 87126
License: G88851
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Surgery Orthopedic
ENCINITAS
92024
Afra, Robert MD
317 N El Camino Real Ste 405
Encinitas, CA 92024
(760) 994-2663
Provider ID: 89641
License: A96247
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 294
SAN DIEGO COUNTY MEDICAL GROUPS GREATER TRI CITIES IPA MEDICAL GROUP INC
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Urology
OCEANSIDE
92056
Phillips, Jason MD
3609 Vista Way
Oceanside, CA 92056
(760) 637-2500
Provider ID: 85963
License: A129806
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 295
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
AFFILIATED HOSPITALS
Above are hospitals you may
visit through this Medical
Group. For a complete listing
of hospital affiliations or to
access another hospital, refer
to page 1319. You will need to
coordinate with your PCP
and/or Medical Group. For
questions, call Blue Shield
Promise Cal MediConnect
Plan Customer Care.
PRIMARY CARE PHYSICIANS
Family Practice
ALPINE
91901
Flores, Jill MD
1620 Alpine Blvd Ste 110
Alpine, CA 91901
(619) 662-4100
Provider ID: 269820
License: A77198
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CAMPO
91906
Rogers, Matthew DO
1388 Buckman Springs Rd
Campo, CA 91906
(619) 662-4100
Provider ID: 277482
License: 20A18400
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CARLSBAD
92009
Bista, Madalasa MD
1905 Calle Barcelona Ste 211
Carlsbad, CA 92009
(858) 799-0933
Provider ID: 269570
License: A145628
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Nepali
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CHULA VISTA
91910
Alb, Ovidiu MD
480 4th Ave Ste 202
Chula Vista, CA 91910
(619) 427-3361
Provider ID: 215100
License: C52597
Credentials and/or board
certification: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 296
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Accepting New Members: Yes accessibility indicators are not certification: No
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Romanian,
Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Alb, Simona MD
480 4th Ave Ste 202
Chula Vista, CA 91910
(619) 427-3361
Provider ID: 215204
License: A98085
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Romanian,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
present.
Aljawadi, Georgia DO
480 4th Ave Ste 202
Chula Vista, CA 91910
(619) 427-3361
Provider ID: 215130
License: 20A11376
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mandoyan, Austin MD
678 3rd Ave
Chula Vista, CA 91910
(619) 662-4100
Provider ID: 277450
License: A161682
Credentials and/or board
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Polak, Clara MD
480 4th Ave Ste 202
Chula Vista, CA 91910
(619) 427-3361
Provider ID: 128074
License: A66649
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 297
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Other Language: Spanish 480 Fourth Ave Ste 202
Cultural Competency: NR Chula Vista, CA 91910
Rabago, Maurellen MD Accessibility: B; Members (619) 427-3361
480 Fourth Ave Ste 202 should call the provider’s Provider ID: 252813
Chula Vista, CA 91910 office to discuss their License: A122649
(619) 427-3361 accessibility needs when there Credentials and/or board
Provider ID: 246730 is limited access or when certification: No
License: A146307 accessibility indicators are not Accepting New Members: No
Credentials and/or board present. Hours: M-SA 9AM-5PM
certification: No PTA: No
Accepting New Members: No Cultural Competency: NR
Hours: M-SA 9AM-5PM Whitley, Nicholas MD Accessibility: B; Members
PTA: No 678 3rd Ave should call the provider’s
Cultural Competency: NR Chula Vista, CA 91910 office to discuss their
Accessibility: B; Members (619) 662-4100 accessibility needs when there
should call the provider’s Provider ID: 253188 is limited access or when
office to discuss their License: A118250 accessibility indicators are not
accessibility needs when there Credentials and/or board present.
is limited access or when certification: No
accessibility indicators are not Accepting New Members: Yes 91911 present. Hours: M-SA 9AM-5PM
PTA: Yes Elsayed, Mohammed MD
Other Language: Spanish 330 Oxford St Ste 106
Stillwell, Carla MD Cultural Competency: NR Chula Vista, CA 91911
480 4th Ave Ste 202 Accessibility: B; Members (619) 409-1802
Chula Vista, CA 91910 should call the provider’s Provider ID: 126700
(619) 427-3361 office to discuss their License: A100765
Provider ID: 215254 accessibility needs when there Credentials and/or board
License: A114687 is limited access or when certification: No
Credentials and/or board accessibility indicators are not Accepting New Members: Yes
certification: Yes present. Hours: M-SA 9AM-5PM
Accepting New Members: Yes PTA: Yes
Hours: M-SA 9AM-5PM Other Language: Arabic,
PTA: Yes Yelanich, Melissa MD German, Spanish
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 298
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
EL CAJON
92019
Almansour, Mumtaz MD
165 S 1st St
El Cajon, CA 92019
(619) 312-0347
Provider ID: 255797
License: A55926
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Kurdish, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
PTA: No
Korkis, Ebtissam MD Other Language: Arabic,
1530 Jamacha Rd Ste E-f Mandarin
El Cajon, CA 92019 Cultural Competency: NR
(619) 441-9200 Accessibility: B; Members
Provider ID: 126908 should call the provider’s
License: A89767 office to discuss their
Credentials and/or board accessibility needs when there
certification: No is limited access or when
Accepting New Members: No accessibility indicators are not
Hours: M-SA 9AM-5PM present.
PTA: No
Other Language: Arabic, 92020 French, Kurdish
Cultural Competency: NR Almansour, Mumtaz MD
Accessibility: B; Members 330 S Magnolia Ave Ste 101
should call the provider’s El Cajon, CA 92020
office to discuss their (619) 593-3007
accessibility needs when there Provider ID: 126614
is limited access or when License: A55926
accessibility indicators are not Credentials and/or board
present. certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
Rouel, Linda MD PTA: Yes
860 Jamacha Rd Ste 107 Other Language: Arabic,
El Cajon, CA 92019 Kurdish, Spanish
(619) 456-9920 Cultural Competency: NR
Provider ID: 126697 Accessibility: B; Members
License: A107575 should call the provider’s
Credentials and/or board office to discuss their
certification: No accessibility needs when there
Accepting New Members: Yes is limited access or when
Hours: M-SA 9AM-5PM accessibility indicators are not
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 299
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
present.
Dominguez, Dennis MD
875 El Cajon Blvd
El Cajon, CA 92020
(619) 441-3550
Provider ID: 277660
License: G43179
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mansour, Wasim DO
330 S Magnolia Ave Ste 101
El Cajon, CA 92020
(619) 593-3007
Provider ID: 244427
License: 20A15860
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92021
Jalisi, Nejat MD
1320 E Madison Ave
El Cajon, CA 92021
(619) 456-9800
Provider ID: 126907
License: A105304
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Farsi, Spanish, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Putrus, Ramiz MD
1032 Broadway
El Cajon, CA 92021
(619) 795-5991
Provider ID: 265252
License: A68184
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
FALLBROOK
92028
Deel, Margaret MD
593 E Elder St Ste B
Fallbrook, CA 92028
(760) 723-5900
Provider ID: 245717
License: C51529
Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 300
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Bista, Madalasa MD
9850 Genesee Ave Ste 320
La Jolla, CA 92037
(858) 864-9800
Provider ID: 269568
License: A145628
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Nepali
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Canelo, Nicholas MD
7855 Ivanhoe Ave Ste 110
La Jolla, CA 92037
(858) 554-1212
Provider ID: 207389
License: A145725
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Kuperman, Ilan MD
9850 Genesee Ave Ste 320
La Jolla, CA 92037
(858) 554-1212
Provider ID: 126909
License: A87018
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Morris, Maisa MD
9850 Genesee Ave Ste 320
La Jolla, CA 92037
(858) 554-1212
Provider ID: 275587
License: C170211
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 301
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Accessibility: B; Members 9850 Genesee Ave Ste 320
Morris, Maisa MD should call the provider’s La Jolla, CA 92037
7855 Ivanhoe Ave Ste 110 office to discuss their (858) 554-1212
La Jolla, CA 92037 accessibility needs when there Provider ID: 126717
(858) 554-1212 is limited access or when License: 20A6331
Provider ID: 275588 accessibility indicators are not Credentials and/or board
License: C170211 present. certification: No
Credentials and/or board Accepting New Members: No
certification: No Hours: M-SA 9AM-5PM
Accepting New Members: No Parrott, Emilia DO PTA: No
Hours: M-SA 9AM-5PM Contract terminated as of Other Language: Spanish
PTA: No 7/31/2021 Cultural Competency: NR
Cultural Competency: NR 9850 Genesee Ave Ste 320 Accessibility: B; Members
Accessibility: B; Members La Jolla, CA 92037 should call the provider’s
should call the provider’s (858) 554-1212 office to discuss their
office to discuss their Provider ID: 207395 accessibility needs when there
accessibility needs when there License: 20A16409 is limited access or when
is limited access or when Credentials and/or board accessibility indicators are not
accessibility indicators are not certification: Yes present.
present. Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No Taylor, Susan MD
Maxson, Christyanne MD Other Language: Polish Contract terminated as of
7855 Ivanhoe Ave Ste 111 Cultural Competency: NR 7/31/2021
La Jolla, CA 92037 Accessibility: B; Members 9850 Genesee Ave Ste 320
(858) 554-1212 should call the provider’s La Jolla, CA 92037
Provider ID: 258329 office to discuss their (858) 554-1212
License: C51943 accessibility needs when there Provider ID: 126718
Credentials and/or board is limited access or when License: G55574
certification: No accessibility indicators are not Credentials and/or board
Accepting New Members: No present. certification: No
Hours: M-SA 9AM-5PM Accepting New Members: Yes
PTA: No Hours: M-SA 9AM-5PM
Cultural Competency: NR Switzer, Jamie DO PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 302
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Tootell, Rhodaline MD
9850 Genesee Ave Ste 320
La Jolla, CA 92037
(858) 554-1212
Provider ID: 265550
License: C160215
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Filipino,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Gurtch, Tim MD
Contract terminated as of
7/31/2021
8875 La Mesa Blvd Ste C
La Mesa, CA 91942
(619) 668-8100
Provider ID: 126902
License: C50806
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Russian,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Sevilla, Marianito MD
2340 E 8th St Ste D
National City, CA 91950
(619) 470-7007
Provider ID: 126703
License: A37097
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Tagalog
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Snook, Brian DO
2400 E 8th St
National City, CA 91950
(619) 662-4100
Provider ID: 265488
License: 20A11518
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 303
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
is limited access or when
accessibility indicators are not
present.
Trimor-tamoria, Maria Flora
MD
2240 E Plaza Blvd Ste A
National City, CA 91950
(619) 267-5884
Provider ID: 126720
License: A55589
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Trimor-tamoria, Maria Flora
MD
502 Euclid Ave Ste 103
National City, CA 91950
(619) 267-5884
Provider ID: 277648
License: A55589
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Magat, Patrocinia MD
15644 Pomerado Rd Ste 100
Poway, CA 92064
(858) 485-5111
Provider ID: 279684
License: A37781
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Chinese,
Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92101
Bhalrhu, Puneet MD
555 W C St Ste 102
San Diego, CA 92101
(858) 554-1212
Provider ID: 252889
License: A158762
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Parrott, Emilia DO
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 304
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Contract terminated as of
7/31/2021
555 W C St Ste 102
San Diego, CA 92101
(858) 554-1212
Provider ID: 207396
License: 20A16409
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Polish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92103
Bhalrhu, Puneet MD
3900 5th Ave Ste 110
San Diego, CA 92103
(858) 554-1212
Provider ID: 252888
License: A158762
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Buchner, William MD
3900 5th Ave Ste 110
San Diego, CA 92103
(858) 554-1212
Provider ID: 126892
License: A109750
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92105
Schumaker, Edward DO
4060 Fairmount Ave
San Diego, CA 92105
(619) 280-4213
Provider ID: 265355
License: 20A6433
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Senethong, Sombath MD
4060 Fairmount Ave
San Diego, CA 92105
(619) 584-1612
Provider ID: 265357
License: A36779
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Lao,
Spanish, Tagalog, Thai
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 305
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92109
Bahmanpour, Kaveh MD
3023 Bunker Hill St Ste 106
San Diego, CA 92109
(858) 270-0010
Provider ID: 265368
License: A109450
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92111
Ahn, Edward MD
7750 Dagget St Ste 108 Accessibility: B, W; Members
San Diego, CA 92111 should call the provider’s
(858) 571-1004 office to discuss their
Provider ID: 126613 accessibility needs when there
License: A38304 is limited access or when
Credentials and/or board accessibility indicators are not
certification: No present.
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes Rim, Choon MD
Other Language: Korean 7825 Engineer Rd Ste 101
Cultural Competency: NR San Diego, CA 92111
Accessibility: B; Members (858) 277-7111
should call the provider’s Provider ID: 126693
office to discuss their License: C50815
accessibility needs when there Credentials and/or board
is limited access or when certification: Yes
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Korean,
Park, Ro Jong MD Spanish
7825 Engineer Rd Ste 101 Cultural Competency: NR
San Diego, CA 92111 Accessibility: B; Members
(858) 277-7111 should call the provider’s
Provider ID: 126626 office to discuss their
License: C51913 accessibility needs when there
Credentials and/or board is limited access or when
certification: No accessibility indicators are not
Accepting New Members: Yes present.
Hours: M-SA 9AM-5PM
PTA: Yes 92113 Other Language: Korean
Cultural Competency: NR Alvarez-estrada, Miguel MD
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 306
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
3177 Ocean View Blvd office to discuss their Provider ID: 274820
San Diego, CA 92113 accessibility needs when there License: A162332
(619) 232-5922 is limited access or when Credentials and/or board
Provider ID: 270466 accessibility indicators are not certification: No
License: A157505 present. Accepting New Members: Yes
Credentials and/or board Hours: M-SA 9AM-5PM
certification: No PTA: No
Accepting New Members: Yes Kaufhold, Anne MD Cultural Competency: NR
Hours: M-SA 9AM-5PM 3177 Ocean View Blvd Accessibility: B; Members
PTA: No San Diego, CA 92113 should call the provider’s
Cultural Competency: NR (619) 662-4100 office to discuss their
Accessibility: B; Members Provider ID: 246615 accessibility needs when there
should call the provider’s License: A88893 is limited access or when
office to discuss their Credentials and/or board accessibility indicators are not
accessibility needs when there certification: No present.
is limited access or when Accepting New Members: Yes
accessibility indicators are not Hours: M-SA 9AM-5PM
present. PTA: Yes Shihata, Alfred MD
Other Language: Arabic, 3802 National Ave
Spanish San Diego, CA 92113
Dappen, Amanda MD Cultural Competency: NR (619) 264-2591
3177 Ocean View Blvd Accessibility: B; Members Provider ID: 126708
San Diego, CA 92113 should call the provider’s License: A37090
(619) 662-4100 office to discuss their Credentials and/or board
Provider ID: 246965 accessibility needs when there certification: No
License: A153414 is limited access or when Accepting New Members: Yes
Credentials and/or board accessibility indicators are not Hours: M-SA 9AM-5PM
certification: No present. PTA: Yes
Accepting New Members: Yes Other Language: Arabic,
Hours: M-SA 9AM-5PM Spanish
PTA: No Morales, Alejandra MD Cultural Competency: NR
Cultural Competency: NR 3177 Ocean View Blvd Accessibility: B, W; Members
Accessibility: B; Members San Diego, CA 92113 should call the provider’s
should call the provider’s (619) 662-4100 office to discuss their
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 307
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
accessibility needs when there Credentials and/or board is limited access or when
is limited access or when certification: No accessibility indicators are not
accessibility indicators are not Accepting New Members: Yes present.
present. Hours: M-SA 9AM-5PM
PTA: No 92115
92114 Cultural Competency: NR
Accessibility: B; Members Dao, Viet MD
Fambro, Cynthia MD should call the provider’s 4616 El Cajon Blvd Ste 9
950 S Euclid Ave office to discuss their San Diego, CA 92115
San Diego, CA 92114 accessibility needs when there (619) 583-0553
(619) 662-4100 is limited access or when Provider ID: 126681
Provider ID: 245427 accessibility indicators are not License: A96409
License: A153223 present. Credentials and/or board
Credentials and/or board certification: No
certification: No Accepting New Members: Yes
Accepting New Members: Yes Wyatt, Tynan MD Hours: M-SA 9AM-5PM
Hours: M-SA 9AM-5PM Contract terminated as of PTA: No
PTA: No 7/31/2021 Cultural Competency: NR
Cultural Competency: NR 950 S Euclid Ave Accessibility: B; Members
Accessibility: B; Members San Diego, CA 92114 should call the provider’s
should call the provider’s (619) 662-4100 office to discuss their
office to discuss their Provider ID: 253198 accessibility needs when there
accessibility needs when there License: A146408 is limited access or when
is limited access or when Credentials and/or board accessibility indicators are not
accessibility indicators are not certification: No present.
present. Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No Le, Tram MD
Scott, Lagina MD Other Language: Spanish 5507 El Cajon Blvd # L
292 Euclid Ave Ste 210 Cultural Competency: NR San Diego, CA 92115
San Diego, CA 92114 Accessibility: B; Members (619) 286-2789
(619) 662-4100 should call the provider’s Provider ID: 126910
Provider ID: 277458 office to discuss their License: A105829
License: A160489 accessibility needs when there Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 308
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish,
Vietnamese
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92116
Parrott, Emilia DO
Contract terminated as of
8/31/2021
4142 Adams Ave Ste 102
San Diego, CA 92116
(858) 554-1212
Provider ID: 278378
License: 20A16409
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Polish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Taylor, Susan MD
Contract terminated as of
8/31/2021
4142 Adams Ave Ste 102
San Diego, CA 92116
(858) 554-1212
Provider ID: 278393
License: G55574
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92117
Hamidi, Mahshid MD
5222 Balboa Ave Ste 31
San Diego, CA 92117
(858) 565-6394
Provider ID: 126903
License: A63702
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Faroese,
Farsi, Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Yuen, Selene MD
4282 Genesee Ave Ste 102
San Diego, CA 92117
(858) 598-6789
Provider ID: 126722
License: A99615
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 309
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92120
Marquis, Paul MD
Contract terminated as of
6/30/2021
6386 Alvarado Ct Ste 101
San Diego, CA 92120
(858) 554-1212
Provider ID: 275606
License: G161976
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Shamani, Azam MD
5555 Reservoir Dr Ste 312
San Diego, CA 92120
(619) 639-7285
Provider ID: 215260
License: A109713
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Faroese,
Farsi, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92121
Dembo Smeaton, Elena MD
Contract terminated as of
8/31/2021
4520 Executive Dr Ste 105
San Diego, CA 92121
(858) 450-5900
Provider ID: 126686
License: A82203
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Russian
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92122
Jenkin, Frederick DO
3562 Governor Dr Ste 1
San Diego, CA 92122
(858) 774-5157
Provider ID: 255591
License: 20A5034
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92130
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 310
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Bista, Madalasa MD Cultural Competency: NR
12843 El Camino Real Ste 203 Accessibility: B; Members
San Diego, CA 92130 should call the provider’s
(858) 554-1212 office to discuss their
Provider ID: 269569 accessibility needs when there
License: A145628 is limited access or when
Credentials and/or board accessibility indicators are not
certification: No present.
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No Szmidt, Maria MD
Other Language: Nepali 12395 El Camino Real Ste 100
Cultural Competency: NR San Diego, CA 92130
Accessibility: B; Members (858) 259-5655
should call the provider’s Provider ID: 209767
office to discuss their License: A52235
accessibility needs when there Credentials and/or board
is limited access or when certification: No
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM
PTA: No
Other Language: Polish,
Soliman, Youstina MD Russian, Spanish
12843 El Camino Real Ste 203 Cultural Competency: NR
San Diego, CA 92130 Accessibility: B; Members
(858) 554-1212 should call the provider’s
Provider ID: 259840 office to discuss their
License: C160848 accessibility needs when there
Credentials and/or board is limited access or when
certification: No accessibility indicators are not
Accepting New Members: Yes present.
Hours: M-SA 9AM-5PM
PTA: No 92154 Other Language: Arabic
Villa, Maria MD
655 Saturn Blvd Ste J
San Diego, CA 92154
(619) 575-4442
Provider ID: 214256
License: A86224
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN YSIDRO
92173
Alvarez-estrada, Miguel MD
4004 Beyer Blvd
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 269585
License: A157505
Credentials and/or board
certification: No
Accepting New Members: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 311
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Hours: M-SA 9AM-5PM 4004 Beyer Blvd Accessibility: B; Members
PTA: No San Ysidro, CA 92173 should call the provider’s
Cultural Competency: NR (619) 662-4100 office to discuss their
Accessibility: B; Members Provider ID: 242432 accessibility needs when there
should call the provider’s License: A152166 is limited access or when
office to discuss their Credentials and/or board accessibility indicators are not
accessibility needs when there certification: No present.
is limited access or when Accepting New Members: Yes
accessibility indicators are not Hours: M-SA 9AM-5PM
present. PTA: No Fellman, Anna MD
Other Language: Spanish 4004 Beyer Blvd
Cultural Competency: NR San Ysidro, CA 92173
Alvarez-estrada, Miguel MD Accessibility: B; Members (619) 662-4100
4050 Beyer Blvd should call the provider’s Provider ID: 279211
San Ysidro, CA 92173 office to discuss their License: A138371
(619) 205-1967 accessibility needs when there Credentials and/or board
Provider ID: 270465 is limited access or when certification: No
License: A157505 accessibility indicators are not Accepting New Members: No
Credentials and/or board present. Hours: M-SA 9AM-5PM
certification: No PTA: No
Accepting New Members: Yes Cultural Competency: NR
Hours: M-SA 9AM-5PM Croughan, Stephen MD Accessibility: B; Members
PTA: No 4004 Beyer Blvd should call the provider’s
Cultural Competency: NR San Ysidro, CA 92173 office to discuss their
Accessibility: B; Members (619) 662-4100 accessibility needs when there
should call the provider’s Provider ID: 245361 is limited access or when
office to discuss their License: A41669 accessibility indicators are not
accessibility needs when there Credentials and/or board present.
is limited access or when certification: No
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM Ferraiolo, Natalie MD
PTA: No 4004 Beyer Blvd
Other Language: Spanish San Ysidro, CA 92173
Caine, Teah MD Cultural Competency: NR (619) 662-4100
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 312
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Provider ID: 245471 is limited access or when certification: No
License: A152372
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hernandez, Ralph MD
3364 Beyer Blvd
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 245261
License: C42207
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
accessibility indicators are not
present.
Navarro, Vanessa MD
3364 Beyer Blvd Ste 103
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 254845
License: A113624
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Otanez Cervantes, Jorge MD
4004 Beyer Blvd
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 255977
License: A153220
Credentials and/or board
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rodriguez, Allen MD
4004 Beyer Blvd
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 253172
License: A163327
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 313
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Rajaipour, Negin MD
3364 Beyer Blvd
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 245396
License: A145480
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Snyder, Christopher DO
4004 Beyer Blvd
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 245316
License: 20A7502
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sweet, Patrick MD
4004 Beyer Blvd
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 253751
License: A101827
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
VISTA
92084
Neff, Jennifer MD
204 S Santa Fe Ave
Vista, CA 92084
(858) 554-1212
Provider ID: 276971
License: A80392
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
Hmong
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
General Practice
CARLSBAD
92009
Alexander, Sandra MD
1905 Calle Barcelona Ste 211
Carlsbad, CA 92009
(858) 554-1212
Provider ID: 272563
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 314
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
License: C169320
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Portuguese,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
DEL MAR
92014
Kremer, Arnold DO
1349 Camino Del Mar Ste B
Del Mar, CA 92014
(858) 925-8233
Provider ID: 128153
License: 20A4242
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ENCINITAS
92024
Farsad, Ramin MD
477 N El Camino Real Ste A100
Encinitas, CA 92024
(760) 943-9111
Provider ID: 252942
License: G80982
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Farsi,
Fataleka, Turkish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Lopez, Irma MD
1035 E Grand Ave Ste 101
Escondido, CA 92025
(760) 480-4747
Provider ID: 259228
License: G57022
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Stern, Anna MD
9850 Genesee Ave Ste 320
La Jolla, CA 92037
(858) 554-1212
Provider ID: 126716
License: A88573
Credentials and/or board
certification: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 315
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Medina, Natalie MD
502 Euclid Ave Ste 306
National City, CA 91950
(619) 267-1168
Provider ID: 278264
License: A54817
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92105
Recalde, Francisco MD
3811 El Cajon Blvd
San Diego, CA 92105
(619) 284-5622
Provider ID: 126692
License: C41872
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92111
Vo, Duc MD
2418 Ulric St
San Diego, CA 92111
(858) 560-1226
Provider ID: 126721
License: A43289
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish,
Vietnamese
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92115
Dwabe, Kefah MD
4863 El Cajon Blvd # A
San Diego, CA 92115
(619) 286-9000
Provider ID: 126690
License: A94193
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic,
Burmese, Cambodian, Thai
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 316
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
office to discuss their License: G42131 accessibility needs when there
accessibility needs when there Credentials and/or board is limited access or when
is limited access or when certification: No accessibility indicators are not
accessibility indicators are not Accepting New Members: Yes present.
present. Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish Mirkarimi, Morteza MD
Sidrick, Nadine MD Cultural Competency: NR 3863 Clairemont Dr
4440 Euclid Ave Ste C Accessibility: B; Members San Diego, CA 92117
San Diego, CA 92115 should call the provider’s (858) 483-5570
(619) 582-5105 office to discuss their Provider ID: 129195
Provider ID: 126709 accessibility needs when there License: A39662
License: G42131 is limited access or when Credentials and/or board
Credentials and/or board accessibility indicators are not certification: No
certification: No present. Accepting New Members: Yes
Accepting New Members: No Hours: M-SA 9AM-5PM
Hours: M-SA 9AM-5PM 92117 PTA: Yes
PTA: No Other Language: Farsi,
Other Language: Spanish Kidokoro, Yasuko MD Fataleka, Spanish
Cultural Competency: NR 5222 Balboa Ave Ste 31 Cultural Competency: NR
Accessibility: B; Members San Diego, CA 92117 Accessibility: B, W; Members
should call the provider’s (858) 277-9669 should call the provider’s
office to discuss their Provider ID: 259602 office to discuss their
accessibility needs when there License: A32727 accessibility needs when there
is limited access or when Credentials and/or board is limited access or when
accessibility indicators are not certification: No accessibility indicators are not
present. Accepting New Members: Yes present.
Hours: M-SA 9AM-5PM
PTA: No 92126 Sidrick, Nadine MD Other Language: Japanese
4690 El Cajon Blvd Cultural Competency: NR Razon, Annabelle MD
San Diego, CA 92115 Accessibility: B; Members 9190 Mira Mesa Blvd
(619) 662-4100 should call the provider’s San Diego, CA 92126
Provider ID: 279711 office to discuss their (858) 689-1814
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 317
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Provider ID: 126684
License: A42407
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92128
Hegyi, Edit MD
16769 Bernardo Center Dr Ste
K13
San Diego, CA 92128
(760) 990-3523
Provider ID: 244768
License: A89002
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
Hungarian
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92154
Borrero, Marcos MD
3490 Palm Ave
San Diego, CA 92154
(619) 423-5616
Provider ID: 126615
License: A38907
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Gerbatsch-bornemisza, Ildiko
MD
3490 Palm Ave
San Diego, CA 92154
(619) 423-5616
Provider ID: 126898
License: A63645
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Internal Medicine
ALPINE
91901
Mueller, Laurel DO
1620 Alpine Blvd Ste 110
Alpine, CA 91901
(619) 662-4100
Provider ID: 273666
License: 20A18030
Credentials and/or board
certification: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 318
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CHULA VISTA
91910
Espinosa-melendez, Enrique
MD
480 4th Ave Ste 507
Chula Vista, CA 91910
(619) 477-7779
Provider ID: 126894
License: C42745
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
Portuguese, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Fadhil, Ali MD
340 Fourth Ave Ste 9
Chula Vista, CA 91910
(619) 426-9731
Provider ID: 244515
License: A145663
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mondragon, Gustavo MD
480 4th Ave Ste 500
Chula Vista, CA 91910
(619) 656-5252
Provider ID: 126917
License: A40640
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Pena, Jose MD
374 H St Ste 103
Chula Vista, CA 91910
(619) 691-1766
Provider ID: 126724
License: C50688
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 319
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Hours: M-SA 9AM-5PM
PTA: No
Uwedjojevwe, Leticia MD
340 Fourth Ave Ste 10
Chula Vista, CA 91910
(619) 934-2215
Provider ID: 128020
License: A80329
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
Credentials and/or board
certification: No
accessibility needs when there
is limited access or when
Accepting New Members: Yes accessibility indicators are not
Hours: M-SA 9AM-5PM
PTA: No
present.
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
Lopez, Jose MD
2648 Main St Ste A
should call the provider’s Chula Vista, CA 91911
office to discuss their
accessibility needs when there
(619) 575-5000
Provider ID: 242483
is limited access or when License: A43301
accessibility indicators are not
present.
Credentials and/or board
certification: Yes
91911
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
De La Rosa, Renato MD
754 Medical Center Ct Ste 103
Chula Vista, CA 91911
(619) 397-5001
Provider ID: 265545
License: A65330
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
Credentials and/or board
certification: No
accessibility needs when there
is limited access or when
Accepting New Members: Yes accessibility indicators are not
present.
EL CAJON
92019
Rouel, Wadi MD
860 Jamacha Rd Ste 107
El Cajon, CA 92019
(619) 456-9920
Provider ID: 126698
License: C55979
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92020
Elias, Ramiz MD
231 W Main St Fl 2
El Cajon, CA 92020
(619) 631-7300
Provider ID: 127986
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 320
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
License: A99956
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Farsi, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Khamooshian, Kourosh MD
875 El Cajon Blvd
El Cajon, CA 92020
(619) 662-4100
Provider ID: 277695
License: A110901
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish, Turkish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92021
Khanna, Poornima MD
1032 Broadway
El Cajon, CA 92021
(619) 795-5991
Provider ID: 229576
License: A70714
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Kannada
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Toulouie, Elahe MD
1580 N 2nd St
El Cajon, CA 92021
(619) 447-2425
Provider ID: 211606
License: A73141
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Armenian,
Farsi, German
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ENCINITAS
92024
Kalina, Mark MD
477 N El Camino Real Ste A200
Encinitas, CA 92024
(858) 766-6007
Provider ID: 278533
License: A49274
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 321
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92027
Al-asady, Noor DO
255 N Ash St Ste 101
Escondido, CA 92027
(619) 662-4100
Provider ID: 274264
License: 20A14791
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Ehrlich, Dennis MD
8950 Villa La Jolla Dr Ste C129
La Jolla, CA 92037
(858) 450-5900
Provider ID: 279136
License: G45623
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hiser, Daniel MD
8950 Villa La Jolla Dr Ste C129
La Jolla, CA 92037
(858) 450-5900
Provider ID: 279078
License: G47397
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Perlman, Monica MD
9850 Genesee Ave Ste 320
La Jolla, CA 92037
(858) 554-1212
Provider ID: 126650
License: G70356
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rana, Shaunak MD
7855 Ivanhoe Ave Ste 110
La Jolla, CA 92037
(858) 799-0933
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 322
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Provider ID: 275763
License: A117404
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Wright, C Michael MD
9850 Genesee Ave Ste 320
La Jolla, CA 92037
(858) 554-1212
Provider ID: 269505
License: G58919
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Alamar, Ali MD
5565 Grossmont Center Dr Ste
105 Bldg 1
La Mesa, CA 91942
(619) 724-6644
Provider ID: 127921
License: A69613
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Prabaker, Venugopal MD
7339 El Cajon Blvd Ste I
La Mesa, CA 91942
(619) 698-0606
Provider ID: 126666
License: A42653
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic,
Chinese, Polish, Russian,
Spanish, Tagalog, Tamil, Thai
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Shahbaz, Majid MD
8851 Center Dr Ste 408
La Mesa, CA 91942
(619) 583-1174
Provider ID: 252902
License: A50402
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Faroese,
Farsi, Tagalog
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 323
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Toulouie, Elahe MD
5358 Jackson Dr # 1
La Mesa, CA 91942
(619) 993-8996
Provider ID: 207406
License: A73141
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Armenian,
Farsi, German
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Bautista, Arwinnah MD
1430 E Plaza Blvd Ste E19a
National City, CA 91950
(619) 434-2813
Provider ID: 126891
License: C51221
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Tiangco, Irineo MD
2340 E 8th St Ste J
National City, CA 91950
(619) 479-0320
Provider ID: 265489
License: A52655
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92101
Haring, Kristen MD
555 W C St Ste 102
San Diego, CA 92101
(858) 333-4977
Provider ID: 277592
License: A64751
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 324
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Lichtenstein, Bernard MD
250 Market St
San Diego, CA 92101
(619) 236-0111
Provider ID: 257297
License: A37396
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: German,
Hebrew, Polish, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92102
Nanduri, Ramachander MD
995 Gateway Center Way Ste
202
San Diego, CA 92102
(619) 264-3107
Provider ID: 213479
License: C50916
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Hindi,
Kannada, Spanish, Tamil,
Telugu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92103
Haring, Kristen MD
3900 5th Ave Ste 110
San Diego, CA 92103
(858) 554-1212
Provider ID: 277201
License: A64751
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92105
Khanna, Poornima MD
4060 Fairmount Ave
San Diego, CA 92105
(619) 255-9155
Provider ID: 229575
License: A70714
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Kannada
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92113
Lichtenstein, Bernard MD
3802 National Ave
San Diego, CA 92113
(619) 264-2591
Provider ID: 128898
License: A37396
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 325
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: German,
Hebrew, Polish, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92114
Carrera, Jorge MD
950 S Euclid Ave
San Diego, CA 92114
(619) 662-4100
Provider ID: 265682
License: G58033
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there License: A124891
is limited access or when
accessibility indicators are
Credentials and/or board
not certification: No
present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Hood, Rodney MD
292 Euclid Ave Ste 210
Other Language: Spanish,
Vietnamese
San Diego, CA 92114
(619) 262-7523
Provider ID: 265625
License: G27791
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
Credentials and/or board
certification: Yes
accessibility needs when there
is limited access or when
Accepting New Members: Yes accessibility indicators are not
Hours: M-SA 9AM-5PM
PTA: Yes
present.
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
Nguyen, Tue MD
4551 El Cajon Blvd
San Diego, CA 92115
(619) 280-7185
Provider ID: 276891
is limited access or when License: A49831
accessibility indicators are
present.
not Credentials and/or board
certification: No
92115
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Le, Charles MD
4440 Euclid Ave
San Diego, CA 92115
(619) 521-6812
Provider ID: 238373
Other Language: Vietnamese
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 326
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
accessibility needs when there License: A47821 office to discuss their
is limited access or when
accessibility indicators are not
present.
Prathipati, Kumara MD
4276 54th Pl Ste B
San Diego, CA 92115
(619) 286-3222
Provider ID: 126671
License: A40438
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Hindi,
Spanish, Tagalog, Telugu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Prathipati, Lakshmi MD
4276 54th Pl Ste B
San Diego, CA 92115
(619) 286-3222
Provider ID: 126669
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish,
Tagalog, Telugu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Truong, Tu MD
5069 El Cajon Blvd
San Diego, CA 92115
(619) 583-8705
Provider ID: 243145
License: A50756
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Cambodian,
Spanish, Vietnamese
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Vo, Sony MD
4551 El Cajon Blvd
San Diego, CA 92115
(619) 280-7185
Provider ID: 276277
License: A49788
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92117
Toulouie, Elahe MD
4282 Genesee Ave Ste 204
San Diego, CA 92117
(619) 993-8996
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 327
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Provider ID: 256898
License: A73141
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Armenian,
Farsi, German
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92121
Singhal, Bindu MD
5440 Morehouse Dr Ste 1700
San Diego, CA 92121
(858) 455-7657
Provider ID: 126711
License: A78248
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Hindi,
Punjabi, Spanish, Urdu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92123
Elias, Ramiz MD
7695 Cardinal Ct Ste 375
San Diego, CA 92123
(858) 384-7072
Provider ID: 126699
License: A99956
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Farsi, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Guha Roy, Asim MD
4540 Kearny Villa Rd Ste 106
San Diego, CA 92123
(858) 430-6656
Provider ID: 257034
License: A62010
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Bengali,
Hindi, Malay, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92126
Fabella, Gabriel MD
10737 Camino Ruiz Ste 115
San Diego, CA 92126
(858) 695-1262
Provider ID: 126895
License: A48087
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 328
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Other Language: Japanese,
Spanish, Tagalog
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN YSIDRO
92173
Avery, John DO
4004 Beyer Blvd
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 242382
License: 20A13586
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Diaz-gonzalez, Vicente MD
4004 Beyer Blvd
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 274812
License: A84160
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dillon, Benedict MD
4050 Beyer Blvd
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 270474
License: A111118
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Ogbonnaya-whittlesey,
Sandra MD
4004 Beyer Blvd
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 273351
License: A122336
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Salerno, Mariana MD
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 329
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
4004 Beyer Blvd
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 277445
License: A131021
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sy, Ramon MD
3364 Beyer Blvd
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 254295
License: A51843
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SANTEE
92071
Guerra, Jacqueline MD
120 Town Center Pkwy
Santee, CA 92071
(619) 445-6200
Provider ID: 277501
License: A151449
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
VISTA
92081
Rutman, Michael DO
2355 S Melrose Dr
Vista, CA 92081
(760) 598-0088
Provider ID: 246236
License: 20A4641
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Obstetrics / Gynecology
CHULA VISTA
91910
Reddy, Divya MD
678 Third Ave
Chula Vista, CA 91910
(619) 662-4100
Provider ID: 247279
License: A130224
Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 330
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Hindi,
Kannada, Telugu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SPECIALISTS
Members may not self-refer to
any of the specialists listed
below. To receive covered
services from a specialist you
must receive a referral from
your primary care physician.
Advanced Heart Failure and
Transplant Cardiology
91914
Hoagland, Peter MD
890 Eastlake Pkwy Ste 205
Chula Vista, CA 91914
(858) 244-6800
Provider ID: 275446
License: G54598
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Jaski, Brian MD
890 Eastlake Pkwy Ste 205
Chula Vista, CA 91914
(858) 244-6800
Provider ID: 275474
License: G55011
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92123
Hoagland, Peter MD
3131 Berger Ave Ste 200
San Diego, CA 92123
(858) 244-6800
Provider ID: 275445
License: G54598
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: French,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Jaski, Brian MD
3131 Berger Ave Ste 200
San Diego, CA 92123
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 331
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
(858) 244-6800
Provider ID: 275473
License: G55011
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: French
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Allergy Immunology
LA JOLLA
92037
Jaffer, Adrian MD
9850 Genesee Ave Ste 420
La Jolla, CA 92037
(858) 457-3270
Provider ID: 65723
License: A25563
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92108
Alkatib, Rhonda MD
2655 Camino Del Rio N Ste 120
San Diego, CA 92108
(619) 286-6687
Provider ID: 268622
License: A163910
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Pendleton, Jennifer MD
2655 Camino Del Rio N Ste 120
San Diego, CA 92108
(619) 286-6687
Provider ID: 26514
License: A80748
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92131
Sharma, Kusum MD
10672 Wexford St Ste 280
San Diego, CA 92131
(858) 412-7362
Provider ID: 127875
License: A111243
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 332
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Other Language: Hindi,
Spanish, Urdu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Anesthesiology Pain
Management
ALPINE
91901
Lao, Jesus MD
1392 Tavern Rd
Alpine, CA 91901
(619) 722-4270
Provider ID: 105586
License: A72729
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Chinese,
Mandarin, Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CARLSBAD
92011
Madhav, Sandip MD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 265242
License: A128918
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Gujarati
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Truong, Ngoc DO
6010 Hidden Valley Rd Ste 110
Carlsbad, CA 92011
(760) 607-5350
Provider ID: 273552
License: 20A13556
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Special Expertise: HIV/AIDS
CHULA VISTA
91910
Truong, Ngoc DO
340 Fourth Ave Ste 19
Chula Vista, CA 91910
(619) 761-5308
Provider ID: 273553
License: 20A13556
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Vietnamese
Cultural Competency: NR
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 333
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Special Expertise: HIV/AIDS
ESCONDIDO
92029
Richardson, Henry MD
1340 W Valley Pkwy Ste 201
Escondido, CA 92029
(760) 607-5350
Provider ID: 268456
License: A105294
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Madhav, Sandip MD
9850 Genesee Ave Ste 530
La Jolla, CA 92037
(760) 631-3000
Provider ID: 277675
License: A128918
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Gujarati
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92103
Van Noord, Brandon MD
3969 4th Ave Ste 208
San Diego, CA 92103
(619) 849-5777
Provider ID: 207405
License: A113568
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Anesthesiology
CHULA VISTA
91910
Thompson, Sandra MD
786 Third Ave Ste B
Chula Vista, CA 91910
(619) 425-0797
Provider ID: 265270
License: G156943
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 334
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
is limited access or when License: 20A11914 office to discuss their
accessibility indicators are not
present.
ESCONDIDO
92025
Faruque, Tania MD
255 N Elm St Ste 101
Escondido, CA 92025
(760) 489-1876
Provider ID: 276163
License: A128513
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Khatibi, Nikan DO
160 N Date St
Escondido, CA 92025
(888) 873-6220
Provider ID: 270624
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Chien, Shelby MD
5360 Jackson Dr Ste 100
La Mesa, CA 91942
(619) 713-6514
Provider ID: 259680
License: C163846
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92103
Thompson, Sandra MD
4033 3rd Ave Ste 430
San Diego, CA 92103
(619) 578-3740
Provider ID: 270537
License: G156943
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92123
Chien, Shelby MD
5395 Ruffin Rd Ste 204
San Diego, CA 92123
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 335
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
(858) 571-3630
Provider ID: 259679
License: C163846
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92126
Grovey, Brittany MD
8901 Activity Rd Ste 100
San Diego, CA 92126
(858) 345-4646
Provider ID: 207388
License: A129072
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Lee, Gemayel MD
8901 Activity Rd Ste 100
San Diego, CA 92126
(858) 345-4646
Provider ID: 207399
License: A129129
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Audiologist
CARLSBAD
92008
Alvira, Providence MA
1820 Marron Rd Ste 102
Carlsbad, CA 92008
(760) 434-0125
Provider ID: 254558
License: AU1745
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Alvira, Providence MA
1820 Marron Rd Ste 102
Carlsbad, CA 92008
(760) 434-0125
Provider ID: 254558
License: HA3591
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 336
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
is limited access or when
accessibility indicators are not
present.
Herrera, Charity MA
1820 Marron Rd Ste 102
Carlsbad, CA 92008
(760) 434-0125
Provider ID: 253421
License: AU2110
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CHULA VISTA
91910
Alvira, Providence MA
310 Third Ave Ste C11
Chula Vista, CA 91910
(619) 426-0841
Provider ID: 254553
License: HA3591
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Alvira, Providence MA
310 Third Ave Ste C11
Chula Vista, CA 91910
(619) 426-0841
Provider ID: 254553
License: AU1745
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Crawford, Joyce MS
310 Third Ave Ste C11
Chula Vista, CA 91910
(619) 426-0841
Provider ID: 254942
License: AU2646
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Herrera, Charity MA
310 Third Ave Ste C11
Chula Vista, CA 91910
(619) 426-0841
Provider ID: 253423
License: AU2110
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 337
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Cultural Competency: NR 801 Orange Ave Ste 205 office to discuss their
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CORONADO
92118
Alvira, Providence MA
801 Orange Ave Ste 205
Coronado, CA 92118
(619) 437-8154
Provider ID: 254554
License: AU1745
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Alvira, Providence MA
Coronado, CA 92118
(619) 437-8154
Provider ID: 254554
License: HA3591
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Crawford, Joyce MS
801 Orange Ave Ste 205
Coronado, CA 92118
(619) 437-8154
Provider ID: 254943
License: AU2646
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Herrera, Charity MA
801 Orange Ave Ste 205
Coronado, CA 92118
(619) 437-8154
Provider ID: 253424
License: AU2110
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
EL CAJON
92021
Alvira, Providence MA
1767 E Main St
El Cajon, CA 92021
(619) 440-6516
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 338
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Provider ID: 254555 accessibility indicators are not Hours: M-SA 9AM-5PM
License: HA3591 present. PTA: No
Credentials and/or board Cultural Competency: NR
certification: No Accessibility: B; Members
Accepting New Members: Yes Crawford, Joyce MS should call the provider’s
Hours: M-SA 9AM-5PM 1767 E Main St office to discuss their
PTA: No El Cajon, CA 92021 accessibility needs when there
Cultural Competency: NR (619) 440-6516 is limited access or when
Accessibility: B; Members Provider ID: 254941 accessibility indicators are not
should call the provider’s License: AU2646 present.
office to discuss their Credentials and/or board
accessibility needs when there certification: No
is limited access or when Accepting New Members: Yes Shasky, Gary MA
accessibility indicators are not Hours: M-SA 9AM-5PM 1767 E Main St
present. PTA: No El Cajon, CA 92021
Cultural Competency: NR (619) 440-6516
Accessibility: B; Members Provider ID: 253262
Alvira, Providence MA should call the provider’s License: AU1361
1767 E Main St office to discuss their Credentials and/or board
El Cajon, CA 92021 accessibility needs when there certification: No
(619) 440-6516 is limited access or when Accepting New Members: Yes
Provider ID: 254555 accessibility indicators are not Hours: M-SA 9AM-5PM
License: AU1745 present. PTA: No
Credentials and/or board Cultural Competency: NR
certification: No Accessibility: B; Members
Accepting New Members: Yes Herrera, Charity MA should call the provider’s
Hours: M-SA 9AM-5PM 1767 E Main St office to discuss their
PTA: No El Cajon, CA 92021 accessibility needs when there
Cultural Competency: NR (619) 440-6516 is limited access or when
Accessibility: B; Members Provider ID: 253422 accessibility indicators are not
should call the provider’s License: AU2110 present.
office to discuss their Credentials and/or board
accessibility needs when there certification: No ESCONDIDO is limited access or when Accepting New Members: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 339
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
92025
Alvira, Providence MA
330 W Felicita Ave Ste A4
Escondido, CA 92025
(760) 489-1323
Provider ID: 254552
License: HA3591
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Alvira, Providence MA
330 W Felicita Ave Ste A4
Escondido, CA 92025
(760) 489-1323
Provider ID: 254552
License: AU1745
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Herrera, Charity MA
330 W Felicita Ave Ste A4
Escondido, CA 92025
(760) 489-1323
Provider ID: 253417
License: AU2110
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Alvira, Providence MA
5565 Grossmont Center Dr Ste
463
La Mesa, CA 91942
(619) 589-5414
Provider ID: 254559
License: AU1745
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Alvira, Providence MA
5565 Grossmont Center Dr Ste
463
La Mesa, CA 91942
(619) 589-5414
Provider ID: 254559
License: HA3591
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 340
463
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Crawford, Joyce MS
5565 Grossmont Center Dr Ste
La Mesa, CA 91942
(619) 589-5414
Provider ID: 254940
License: AU2646
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Herrera, Charity MA
5565 Grossmont Center Dr
La Mesa, CA 91942
(619) 589-5414
Provider ID: 253418
License: AU2110
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Herrera, Charity MA
5565 Grossmont Center Dr Ste
463 Bldg 3
La Mesa, CA 91942
(619) 589-5414
Provider ID: 253427
License: AU2110
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92120
Alvira, Providence MA
6367 Alvarado Ct Ste 101
San Diego, CA 92120
(619) 583-7002
Provider ID: 254551
License: HA3591
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Alvira, Providence MA
6367 Alvarado Ct Ste 101
San Diego, CA 92120
(619) 583-7002
Provider ID: 254551
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 341
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
License: AU1745
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Crawford, Joyce MS
6367 Alvarado Ct Ste 101
San Diego, CA 92120
(619) 583-7002
Provider ID: 254944
License: AU2646
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Herrera, Charity MA
6367 Alvarado Ct Ste 101
San Diego, CA 92120
(619) 583-7002
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
Provider ID: 253425
License: AU2110
accessibility needs when there
is limited access or when
Credentials and/or board accessibility indicators are not
certification: No
Accepting New Members: Yes
present.
Hours: M-SA 9AM-5PM
PTA: No Alvira, Providence MA
Cultural Competency: NR 9340 Clairemont Mesa Blvd Ste
Accessibility: B; Members D
should call the provider’s
office to discuss their
accessibility needs when there
San Diego, CA 92123
(858) 278-9911
Provider ID: 254556
is limited access or when License: AU1745
accessibility indicators are not
present.
Credentials and/or board
certification: No
92123
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Alvira, Providence MA
9340 Clairemont Mesa Blvd Ste
D
San Diego, CA 92123
(858) 278-9911
Provider ID: 254556
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
License: HA3591
Credentials and/or board
certification: No
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 342
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Crawford, Joyce MS
9340 Clairemont Mesa Blvd Ste
D
San Diego, CA 92123
(858) 278-9911
Provider ID: 254938
License: AU2646
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Herrera, Charity MA
9340 Clairemont Mesa Blvd Ste
D
San Diego, CA 92123
(858) 278-9911
Provider ID: 253420
License: AU2110
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Shasky, Gary MA
9340 Clairemont Mesa Blvd Ste
D
San Diego, CA 92123
(858) 278-9911
Provider ID: 253263
License: AU1361
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SOLANA BEACH
92075
Alvira, Providence MA
740 Lomas Santa Fe Dr Ste 110
Solana Beach, CA 92075
(858) 259-4182
Provider ID: 254557
License: AU1745
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Alvira, Providence MA
740 Lomas Santa Fe Dr Ste 110
Solana Beach, CA 92075
(858) 259-4182
Provider ID: 254557
License: HA3591
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 343
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Crawford, Joyce MS
740 Lomas Santa Fe Dr Ste 110
Solana Beach, CA 92075
(858) 259-4182
Provider ID: 254939
License: AU2646
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Herrera, Charity MA
740 Lomas Santa Fe Dr
Solana Beach, CA 92075
(858) 259-4182
Provider ID: 253419
License: AU2110
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Cardiac Electrophysiology
ENCINITAS
92024
Hamzei, Ali MD
320 Santa Fe Dr Ste 204
Encinitas, CA 92024
(760) 944-7300
Provider ID: 272339
License: A62682
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Farsi
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Hamzei, Ali MD
9850 Genesee Ave Ste 780
La Jolla, CA 92037
(858) 824-2900
Provider ID: 272340
License: A62682
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 344
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Whitwam, Wayne MD
9850 Genesee Ave Ste 780
La Jolla, CA 92037
(858) 450-3388
Provider ID: 65744
License: A90625
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Cardiology
CHULA VISTA
91910
Aizin, Vitali MD
321 E St Ste A
Chula Vista, CA 91910
(619) 934-3260
Provider ID: 103813
License: A82761
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Russian,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Berman, Brett MD
321 E St Ste A
Chula Vista, CA 91910
(619) 934-3260
Provider ID: 35528
License: A78854
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
91911
Pugh, Matthew DO
754 Medical Center Ct Ste 206
Chula Vista, CA 91911
(619) 482-4333
Provider ID: 265215
License: 20A12102
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
EL CAJON
92020
Kafri, Hassan MD
328 Highland Ave Ste 200
El Cajon, CA 92020
(619) 930-9404
Provider ID: 240321
License: A96002
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 345
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Farsi, German, Russian,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Zavaro, Suhail MD
300 S Pierce St # 102
El Cajon, CA 92020
(619) 668-4700
Provider ID: 241921
License: A46162
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic,
Spanish, Tagalog
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Cohen, David MD
9850 Genesee Ave Ste 940
La Jolla, CA 92037
(858) 658-0020
Provider ID: 127778
License: A110351
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Pandhi, Jay MD
655 Euclid Ave Ste 208
National City, CA 91950
(619) 512-1915
Provider ID: 269088
License: C56015
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Cardiovascular Disease
CHULA VISTA
91910
Kafri, Hassan MD
429 Broadway
Chula Vista, CA 91910
(619) 434-0204
Provider ID: 259905
License: A96002
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 346
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
PTA: No
Other Language: Arabic,
Farsi, German, Russian,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
91911
Moussavian, Mehran DO
765 Medical Center Ct Ste 211
Chula Vista, CA 91911
(619) 616-2100
Provider ID: 238395
License: 20A7241
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rough, Steven MD
750 Medical Center Ct Ste 3
Chula Vista, CA 91911
(619) 434-4288
Provider ID: 275470
License: A124001
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Shetabi, Kambiz MD
765 Medical Center Ct Ste 211
Chula Vista, CA 91911
(619) 616-2100
Provider ID: 257163
License: A126187
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
91914
Cepin, Daniel MD
890 Eastlake Pkwy Ste 205
Chula Vista, CA 91914
(619) 482-0300
Provider ID: 276989
License: G52521
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 347
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
present. PTA: No present.
Gordon, John MD
890 Eastlake Pkwy Ste 203
Chula Vista, CA 91914
(858) 244-6800
Provider ID: 278285
License: C42631
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mehta, Hirsch MD
890 Eastlake Pkwy Ste 205
Chula Vista, CA 91914
(858) 244-6800
Provider ID: 275526
License: A105910
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
EL CAJON
92020
Hourani, Rayan MD
300 S Pierce St # 102
El Cajon, CA 92020
(619) 668-4700
Provider ID: 241994
License: A119614
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Farsi, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
92021
Moussavian, Mehran DO
1625 E Main St Ste 201
El Cajon, CA 92021
(619) 486-6512
Provider ID: 248176
License: 20A7241
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Shetabi, Kambiz MD
1625 E Main St Ste 201
El Cajon, CA 92021
(619) 486-6512
Provider ID: 278855
License: A126187
Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 348
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ENCINITAS
92024
Avalos, Roy MD
320 Santa Fe Dr Ste 204
Encinitas, CA 92024
(760) 944-7300
Provider ID: 257178
License: A68893
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Backman, John MD
320 Santa Fe Dr Ste 204
Encinitas, CA 92024
(760) 944-7300
Provider ID: 265195
License: G29156
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Jacoby, Richard MD
700 Garden View Ct Ste 204
Encinitas, CA 92024
(760) 452-6334
Provider ID: 257039
License: G161416
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Kulhanek, Jan MD
320 Santa Fe Dr Ste 204
Encinitas, CA 92024
(760) 944-7300
Provider ID: 265265
License: A102299
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Czech
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 349
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Mcginty, Patrick MD
320 Santa Fe Dr Ste 204
Encinitas, CA 92024
(760) 944-7300
Provider ID: 265220
License: A94682
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mehboob, Salman MD
700 Garden View Ct Ste 204
Encinitas, CA 92024
(760) 452-6334
Provider ID: 257032
License: A119955
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Urdu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rasch, Damian DO
320 Santa Fe Dr Ste 204
Encinitas, CA 92024
(760) 944-7300
Provider ID: 265224
License: 20A14015
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Moussavian, Mehran DO
488 E Valley Pkwy Ste 107
Escondido, CA 92025
(760) 294-0480
Provider ID: 278815
License: 20A7241
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Shetabi, Kambiz MD
488 E Valley Pkwy Ste 107
Escondido, CA 92025
(760) 294-0480
Provider ID: 278853
License: A126187
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 350
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Avalos, Roy MD
9850 Genesee Ave Ste 780
La Jolla, CA 92037
(858) 824-2900
Provider ID: 272508
License: A68893
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Costello, Dennis MD
9850 Genesee Ave Ste 430
La Jolla, CA 92037
(858) 450-3388
Provider ID: 259911
License: G33998
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mendenhall, George MD
9850 Genesee Ave Ste 940
La Jolla, CA 92037
(858) 658-0020
Provider ID: 127795
License: C152874
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Russo, Robert MD
9850 Genesee Ave Ste 350
La Jolla, CA 92037
(858) 886-7595
Provider ID: 105088
License: G62682
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Azimi, Nassir MD
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 351
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
5565 Grossmont Center Dr Ste
3 Ste 444
La Mesa, CA 91942
(619) 784-1060
Provider ID: 259741
License: A91478
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mehranpour, Payam MD
8851 Center Dr Ste 405
La Mesa, CA 91942
(619) 377-6262
Provider ID: 252973
License: A112670
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Farsi, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Kim, James MD
502 Euclid Ave Ste 104
National City, CA 91950
(619) 434-4288
Provider ID: 275402
License: A121180
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Korean,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Ly, Nancy MD
502 Euclid Ave Ste 104
National City, CA 91950
(619) 434-4288
Provider ID: 275480
License: A125595
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Nanavati, Vimal MD
2345 E 8th St Ste 111
National City, CA 91950
(619) 585-0476
Provider ID: 270830
License: G83522
Credentials and/or board
certification: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 352
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Oviedo-linares, Raul MD
502 Euclid Ave Ste 104
National City, CA 91950
(619) 434-4288
Provider ID: 275482
License: A76050
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Polish,
Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rough, Steven MD
502 Euclid Ave Ste 104
National City, CA 91950
(619) 434-4288
Provider ID: 275469
License: A124001
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Wysoczanski, Mariusz MD
502 Euclid Ave Ste 104
National City, CA 91950
(619) 434-4288
Provider ID: 275513
License: C55986
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Polish,
Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Nanavati, Vimal MD
15706 Pomerado Rd Ste 104
Poway, CA 92064
(619) 585-0476
Provider ID: 268058
License: G83522
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 353
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
SAN DIEGO
92103
Glassman, Jerrold MD
4060 4th Ave Ste 650
San Diego, CA 92103
(619) 819-7222
Provider ID: 246319
License: G34309
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Keramati, Shahin MD
501 Washington St Ste 512
San Diego, CA 92103
(619) 297-0014
Provider ID: 53717
License: G80033
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Farsi
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mai, Tuan MD
501 Washington St Ste 512
San Diego, CA 92103
(619) 297-0014
Provider ID: 265367
License: A113870
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Salami, Bobak MD
501 Washington St Ste 512
San Diego, CA 92103
(619) 297-0014
Provider ID: 265353
License: A75049
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92105
Ly, Nancy MD
4844 University Ave Ste A
San Diego, CA 92105
(619) 434-4288
Provider ID: 275481
License: A125595
Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 354
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92111
Nguyen, Tri MD
7345 Linda Vista Rd Ste A
San Diego, CA 92111
(858) 277-5463
Provider ID: 269955
License: G79496
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Chinese,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there License: 20A7241
is limited access or when
accessibility indicators are not
Credentials and/or board
certification: No
present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Sclar, Craig MD
7830 Clairemont Mesa Blvd Ste
100
San Diego, CA 92111
(858) 268-1111
Provider ID: 43642
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
License: A36023
Credentials and/or board
accessibility needs when there
is limited access or when
certification: No accessibility indicators are not
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
present.
PTA: Yes
Cultural Competency: NR Shetabi, Kambiz MD
Accessibility: B, W; Members 292 Euclid Ave Ste 210
should call the provider’s
office to discuss their
accessibility needs when there
San Diego, CA 92114
(619) 616-2100
Provider ID: 257164
is limited access or when License: A126187
accessibility indicators are not
present.
Credentials and/or board
certification: No
92114
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Moussavian, Mehran DO
292 Euclid Ave Ste 210
San Diego, CA 92114
(619) 616-2100
Provider ID: 238396
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 355
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
accessibility needs when there Provider ID: 276846 office to discuss their
is limited access or when
accessibility indicators are not
present.
92115
Nguyen, Tri MD
4206 44th St
San Diego, CA 92115
(361) 962-4943
Provider ID: 269954
License: G79496
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Chinese,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sherev, Dimitri MD
6402 El Cajon Blvd Ste 102
San Diego, CA 92115
(619) 582-4490
License: A70917
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Bulgarian,
Malayalam, Russian, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92120
Nanavati, Vimal MD
6655 Alvarado Rd
San Diego, CA 92120
(619) 229-3170
Provider ID: 268056
License: G83522
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92123
Gordon, John MD
3131 Berger Ave Ste 200
San Diego, CA 92123
(858) 244-6800
Provider ID: 278284
License: C42631
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mehta, Hirsch MD
3131 Berger Ave Ste 200
San Diego, CA 92123
(858) 244-6800
Provider ID: 275525
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 356
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
License: A105910
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92127
Moussavian, Mehran DO
16918 Dove Canyon Rd Ste
103
San Diego, CA 92127
(858) 649-5100
Provider ID: 265302
License: 20A7241
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN MARCOS
92078
Moussavian, Mehran DO
955 Boardwalk Ste 100
San Marcos, CA 92078
(619) 616-2100
Provider ID: 238397
License: 20A7241
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Shetabi, Kambiz MD
955 Boardwalk Ste 100
San Marcos, CA 92078
(760) 798-8855
Provider ID: 278854
License: A126187
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN YSIDRO
92173
Aizin, Vitali MD
4630 Border Village Rd Ste H
San Ysidro, CA 92173
(619) 428-3780
Provider ID: 254961
License: A82761
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 357
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Other Language: Russian,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
VISTA
92083
Bui, Hanh MD
2067 W Vista Way Ste 225
Vista, CA 92083
(760) 630-2550
Provider ID: 259728
License: A79185
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Chinese,
Spanish, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Holland, Marian MD
2067 W Vista Way Ste 225
Vista, CA 92083
(760) 630-2550
Provider ID: 276890
License: A100523
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Certified Acupuncturist
CHULA VISTA
91910
Wilcox, Wenonah LAC
786 Third Ave Ste B
Chula Vista, CA 91910
(619) 425-0797
Provider ID: 265547
License: AC13675
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Certified Nurse Practitioner
CAMPO
91906
Hurley, Teresa NP
1388 Buckman Springs Rd
Campo, CA 91906
(619) 662-4100
Provider ID: 265473
License: NP95012693
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 358
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CARLSBAD
92009
Halpern, David NP
Contract terminated as of
7/31/2021
1905 Calle Barcelona Ste 211
Carlsbad, CA 92009
(858) 799-0933
Provider ID: 275643
License: NP95008040
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92011
Batac, Nadine NP
6010 Hidden Valley Rd Ste 110
Carlsbad, CA 92011
(858) 432-7880
Provider ID: 254563
License: NP21763
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Bierman, Andrew NP
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 252271
License: NP95011909
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Bishop, Leslie NP
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 252886
License: NP95010047
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Binavi, Hownaz NP
6010 Hidden Valley Rd Ste 120
Carlsbad, CA 92011
(760) 884-5990
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 359
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Provider ID: 272946
License: NP95010956
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Kurdish,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hooper, Bonnie NP
6010 Hidden Valley Rd Ste 120
Carlsbad, CA 92011
(760) 884-5990
Provider ID: 269842
License: NP6495
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CHULA VISTA
91910
Carapia, Fabiola NP
340 4th Ave Ste 4
Chula Vista, CA 91910
(619) 427-1144
Provider ID: 214090
License: NP20855
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Carapia, Fabiola NP
340 4th Ave Ste 4
Chula Vista, CA 91910
(619) 427-1144
Provider ID: 214090
License: RN603937
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Collinsworth, Jessica NP
344 F St Ste 203
Chula Vista, CA 91910
(619) 427-9627
Provider ID: 259725
License: NP95008585
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 360
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
present. PTA: No 880 3rd Ave Ste A
Lopez, Rito NP
340 Fourth Ave Ste 10
Chula Vista, CA 91910
(619) 934-2215
Provider ID: 258168
License: NP95013287
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Spaulding, Enjoli NP
786 Third Ave Ste B
Chula Vista, CA 91910
(619) 425-0797
Provider ID: 265022
License: NP21947
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
Cultural Competency: NR Chula Vista, CA 91911
Accessibility: B; Members (619) 662-4100
should call the provider’s Provider ID: 275530
office to discuss their License: NP95000200
accessibility needs when there Credentials and/or board
is limited access or when certification: No
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM
PTA: No
91911 Cultural Competency: NR
Accessibility: B; Members
Akins, Melanie NP should call the provider’s
752 Medical Center Ct Ste 302 office to discuss their
Chula Vista, CA 91911 accessibility needs when there
(619) 421-3361 is limited access or when
Provider ID: 214065 accessibility indicators are not
License: NP95008069 present.
Credentials and/or board
certification: No
Accepting New Members: Yes Lang, Po NP
Hours: M-SA 9AM-5PM 765 Medical Center Ct Ste 210
PTA: No Chula Vista, CA 91911
Cultural Competency: NR (619) 482-0565
Accessibility: B; Members Provider ID: 278437
should call the provider’s License: NP95016187
office to discuss their Credentials and/or board
accessibility needs when there certification: No
is limited access or when Accepting New Members: Yes
accessibility indicators are not Hours: M-SA 9AM-5PM
present. PTA: No
Cultural Competency: NR
Accessibility: B; Members
Da Cunha, Maria Luisa NP should call the provider’s
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 361
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Ponce, Sarah NP
1058 Third Ave
Chula Vista, CA 91911
(619) 662-4100
Provider ID: 265544
License: NP95005787
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
EL CAJON
92021
Luckett, De Courcy NP
1580 N 2nd St
El Cajon, CA 92021
(619) 447-2425
Provider ID: 259740
License: NP95000435
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Pham, Mary-lysianne NP
1351 Broadway
El Cajon, CA 92021
(619) 383-6703
Provider ID: 276921
License: NP95008968
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sirleaf, Massanu NP
1351 Broadway
El Cajon, CA 92021
(619) 383-6703
Provider ID: 275458
License: NP95000692
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ENCINITAS
92024
Buckley, Patricia NP
326 Santa Fe Dr Ste 105
Encinitas, CA 92024
(760) 452-3340
Provider ID: 279060
License: NP95015705
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 362
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Binavi, Hownaz NP
477 N El Camino Real Ste D308
Encinitas, CA 92024
(760) 436-2300
Provider ID: 272947
License: NP95010956
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Kurdish,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Coyle, Jennifer NP
326 Santa Fe Dr Ste 105
Encinitas, CA 92024
(760) 452-3340
Provider ID: 279276
License: NP95006591
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Herr, Colleen NP
477 N El Camino Real Ste A308
Encinitas, CA 92024
(760) 436-8881
Provider ID: 269056
License: NP11633
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hooper, Bonnie NP
477 N El Camino Real Ste D308
Encinitas, CA 92024
(760) 436-2300
Provider ID: 269843
License: NP6495
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Huynh, Melvyn NP
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 363
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
662 Encinitas Blvd Ste 220 office to discuss their License: NP95009642
Encinitas, CA 92024 accessibility needs when there Credentials and/or board
(833) 446-6363 is limited access or when certification: No
Provider ID: 271794 accessibility indicators are not Accepting New Members: Yes
License: NP95002765 present. Hours: M-SA 9AM-5PM
Credentials and/or board PTA: No
certification: No Cultural Competency: NR
Accepting New Members: Yes Nizheborsky, Oksana NP Accessibility: B; Members
Hours: M-SA 9AM-5PM 320 Santa Fe Dr Ste 107c should call the provider’s
PTA: No Encinitas, CA 92024 office to discuss their
Cultural Competency: NR (760) 230-8994 accessibility needs when there
Accessibility: B; Members Provider ID: 259621 is limited access or when
should call the provider’s License: NP95001042 accessibility indicators are not
office to discuss their Credentials and/or board present.
accessibility needs when there certification: No
is limited access or when Accepting New Members: Yes
accessibility indicators are not Hours: M-SA 9AM-5PM Pidding, Apryl NP
present. PTA: No 700 Garden View Ct Ste 102
Other Language: Russian Encinitas, CA 92024
Cultural Competency: NR (760) 783-0441
Myers, Jesse NP Accessibility: B; Members Provider ID: 265372
477 N El Camino Real Ste A308 should call the provider’s License: NP20027
Encinitas, CA 92024 office to discuss their Credentials and/or board
(760) 436-8881 accessibility needs when there certification: No
Provider ID: 271841 is limited access or when Accepting New Members: Yes
License: NP18224 accessibility indicators are not Hours: M-SA 9AM-5PM
Credentials and/or board present. PTA: No
certification: No Cultural Competency: NR
Accepting New Members: Yes Accessibility: B; Members
Hours: M-SA 9AM-5PM Nyagaya, Linda NP should call the provider’s
PTA: No 662 Encinitas Blvd Ste 220 office to discuss their
Cultural Competency: NR Encinitas, CA 92024 accessibility needs when there
Accessibility: B; Members (833) 446-6363 is limited access or when
should call the provider’s Provider ID: 271805 accessibility indicators are not
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 364
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
present.
Reppenhagen, Denise NP
634 Hollyridge Dr
Encinitas, CA 92024
(619) 662-4100
Provider ID: 269845
License: NP19213
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Tawfilis, Amy NP
320 Santa Fe Dr Ste 108
Encinitas, CA 92024
(760) 436-4558
Provider ID: 275702
License: NP95013902
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Woodruff, Whitney NP
700 Garden View Ct Ste 102
Encinitas, CA 92024
(760) 783-0441
Provider ID: 265260
License: NP16535
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Konyn, Catherine NPF
1001 E Grand Ave
Escondido, CA 92025
(760) 520-8200
Provider ID: 246834
License: NP19095
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Spaulding, Enjoli NP
631 E Grand Ave
Escondido, CA 92025
(760) 294-1660
Provider ID: 242014
License: NP21947
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 365
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92029
Batac, Nadine NP
1340 W Valley Pkwy Ste 201
Escondido, CA 92029
(619) 325-1161
Provider ID: 268445
License: NP21763
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Bishop, Leslie NP
1955 Citracado Pkwy Ste 102
Escondido, CA 92029
(760) 630-3000
Provider ID: 277680
License: NP95010047
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
FALLBROOK
92028
Berrios, Alvaro NPF
593 E Elder St Ste B
Fallbrook, CA 92028
(760) 723-5900
Provider ID: 245684
License: NP16355
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Buckley, Patricia NP
9850 Genesee Ave Ste 560
La Jolla, CA 92037
(858) 552-1410
Provider ID: 279062
License: NP95015705
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Goodman, Meagan NP
9850 Genesee Ave Ste 320
La Jolla, CA 92037
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 366
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
(858) 554-1212
Provider ID: 275825
License: NP95005125
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Goshen, Kirsten NP
9850 Genesee Ave Ste 570
La Jolla, CA 92037
(858) 457-4917
Provider ID: 257188
License: NP95005769
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Halpern, David NP
Contract terminated as of
7/31/2021
9850 Genesee Ave Ste 320
La Jolla, CA 92037
(858) 554-1212
Provider ID: 275642
License: NP95008040
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Kovaleski, Natalia PA
Contract terminated as of
6/30/2021
9850 Genesee Ave Ste 320
La Jolla, CA 92037
(858) 554-1212
Provider ID: 269523
License: PA22994
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Silvestri, Nicole NP
Contract terminated as of
7/31/2021
9850 Genesee Ave Ste 320
La Jolla, CA 92037
(858) 554-1212
Provider ID: 278688
License: NP95010137
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 367
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
accessibility needs when there certification: No
is limited access or when Accepting New Members: Yes
accessibility indicators are not Hours: M-SA 9AM-5PM Vierra, Erin NP
present. PTA: No Contract terminated as of
Other Language: Vietnamese 7/31/2021
Cultural Competency: NR 9850 Genesee Ave Ste 320
Tawfilis, Amy NP Accessibility: B; Members La Jolla, CA 92037
9850 Genesee Ave Ste 440 should call the provider’s (858) 554-1212
La Jolla, CA 92037 office to discuss their Provider ID: 278693
(858) 453-5944 accessibility needs when there License: NP95006057
Provider ID: 275701 is limited access or when Credentials and/or board
License: NP95013902 accessibility indicators are not certification: No
Credentials and/or board present. Accepting New Members: No
certification: No Hours: M-SA 9AM-5PM
Accepting New Members: Yes PTA: No
Hours: M-SA 9AM-5PM Tomicich, Stephanie NP Cultural Competency: NR
PTA: No 9850 Genesee Ave Ste 440 Accessibility: B; Members
Cultural Competency: NR La Jolla, CA 92037 should call the provider’s
Accessibility: B; Members (858) 453-5944 office to discuss their
should call the provider’s Provider ID: 275677 accessibility needs when there
office to discuss their License: NP95002402 is limited access or when
accessibility needs when there Credentials and/or board accessibility indicators are not
is limited access or when certification: No present.
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM
PTA: No Weidner, Anne NP
Cultural Competency: NR Contract terminated as of
Tran, Daphne NP Accessibility: B; Members 7/31/2021
9850 Genesee Ave Ste 900 should call the provider’s 9850 Genesee Ave Ste 320
La Jolla, CA 92037 office to discuss their La Jolla, CA 92037
(858) 452-1279 accessibility needs when there (858) 554-1212
Provider ID: 265396 is limited access or when Provider ID: 278687
License: NP95011984 accessibility indicators are not License: NP95009793
Credentials and/or board present. Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 368
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
certification: No certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Yartseva, Yuliya NP
7855 Ivanhoe Ave Ste 101
La Jolla, CA 92037
(858) 554-1212
Provider ID: 213716
License: NP95007558
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Zuniga, Vania NP
Contract terminated as of
7/31/2021
9850 Genesee Ave Ste 320
La Jolla, CA 92037
(858) 554-1212
Provider ID: 278674
License: NP95007433
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Chinese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Loyola, Mary Ann NP
8851 Center Dr Ste 505
La Mesa, CA 91942
(619) 461-3880
Provider ID: 244503
License: NP95011408
Credentials and/or board
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Roh, Dongyon NP
5360 Jackson Dr Ste 100
La Mesa, CA 91942
(619) 713-6514
Provider ID: 259623
License: NP95004887
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Korean
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 369
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
present.
Thomas, Shorena NP
Contract terminated as of
6/30/2021
7339 El Cajon Blvd Ste I
La Mesa, CA 91942
(619) 698-0606
Provider ID: 208940
License: NP95006664
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Polish,
Russian
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Alcantar, Jose NP
655 Euclid Ave Ste 304
National City, CA 91950
(619) 470-7700
Provider ID: 278776
License: NP95003735
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Villanueva De Gutie, Berenice
NP
217 Highland Ave
National City, CA 91950
(619) 434-7308
Provider ID: 279151
License: NP95002188
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
OCEANSIDE
92056
Andolina, Sara NP
3923 Waring Rd Ste A
Oceanside, CA 92056
(760) 724-8782
Provider ID: 259767
License: NP95000358
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Quinn, Erin NP
3998 Vista Way Ste C
Oceanside, CA 92056
(760) 941-1440
Provider ID: 279103
License: NP6812
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 370
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Bishop, Leslie NP
15611 Pomerado Rd Ste 505
Poway, CA 92064
(760) 631-3000
Provider ID: 252887
License: NP95010047
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Travers, Naomi NP
15725 Pomerado Rd Ste 102
Poway, CA 92064
(858) 397-5755
Provider ID: 242463
License: NP12905
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92102
Feizi, Sedi NP
995 Gateway Center Way Ste
207
San Diego, CA 92102
(619) 263-9729
Provider ID: 252958
License: NP95002309
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92103
Binavi, Hownaz NP
4060 4th Ave Ste 415
San Diego, CA 92103
(619) 298-9809
Provider ID: 256105
License: NP95010956
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Kurdish,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 371
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dwyer, Erin NP
4060 4th Ave Ste 310
San Diego, CA 92103
(619) 297-4707
Provider ID: 265299
License: NP95004184
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Jersey, Karen NP
3969 4th Ave Ste 208
San Diego, CA 92103
(619) 848-5777
Provider ID: 259055
License: NP21684
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Medilo, Lovella NP
4033 3rd Ave Ste 430
San Diego, CA 92103
(619) 578-3740
Provider ID: 273463
License: NP95010904
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Thomas, Shorena NP
Contract terminated as of
6/30/2021
4060 4th Ave Ste 220
San Diego, CA 92103
(619) 299-2350
Provider ID: 265394
License: NP95006664
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Polish,
Russian
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92105
Villanueva De Gutie, Berenice
NP
4060 Fairmount Ave
San Diego, CA 92105
(619) 255-9155
Provider ID: 279150
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 372
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
License: NP95002188 is limited access or when certification: No
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92108
Batac, Nadine NP
7525 Metropolitan Dr Ste 302
San Diego, CA 92108
(619) 761-5308
Provider ID: 254564
License: NP21763
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
accessibility indicators are not
present.
92114
Gordon, Danielle NP
292 Euclid Ave Ste 210
San Diego, CA 92114
(619) 662-4100
Provider ID: 269847
License: NP95010963
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92117
Case, Erinn NP
3737 Moraga Ave Ste B103
San Diego, CA 92117
(858) 554-1212
Provider ID: 269644
License: NP95009488
Credentials and/or board
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Yartseva, Yuliya NP
3737 Moraga Ave Ste B103
San Diego, CA 92117
(858) 554-1212
Provider ID: 213715
License: NP95007558
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 373
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
PTA: No92121 Other Language: Kurdish, Quiceno, Michael NP
Bosley, Jazmyne NP Spanish 10251 Vista Sorrento Pkwy Ste
10251 Vista Sorrento Pkwy Ste Cultural Competency: NR 280
280 Accessibility: B; Members San Diego, CA 92121
San Diego, CA 92121 should call the provider’s (818) 575-6351
(818) 575-6351 office to discuss their Provider ID: 279964
Provider ID: 279141 accessibility needs when there License: NP95011137
License: NP95010166 is limited access or when Credentials and/or board
Credentials and/or board accessibility indicators are not certification: No
certification: No present. Accepting New Members: Yes
Accepting New Members: Yes Hours: M-SA 9AM-5PM
Hours: M-SA 9AM-5PM PTA: No
PTA: No Pantoja, Danica-ella NP Other Language: Spanish
Cultural Competency: NR 10251 Vista Sorrento Pkwy Ste Cultural Competency: NR
Accessibility: B; Members 280 Accessibility: B; Members
should call the provider’s San Diego, CA 92121 should call the provider’s
office to discuss their (818) 575-6351 office to discuss their
accessibility needs when there Provider ID: 279148 accessibility needs when there
is limited access or when License: NP95016725 is limited access or when
accessibility indicators are not Credentials and/or board accessibility indicators are not
present. certification: No present.
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
Binavi, Hownaz NP PTA: No Shatswell, Brenna NP
9339 Genesee Ave Ste 350 Cultural Competency: NR 10251 Vista Sorrento Pkwy Ste
San Diego, CA 92121 Accessibility: B; Members 280
(858) 454-4300 should call the provider’s San Diego, CA 92121
Provider ID: 256104 office to discuss their (818) 575-6351
License: NP95010956 accessibility needs when there Provider ID: 279957
Credentials and/or board is limited access or when License: NP95009161
certification: No accessibility indicators are not Credentials and/or board
Accepting New Members: Yes present. certification: No
Hours: M-SA 9AM-5PM Accepting New Members: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 374
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92123
Camargo-lowthers, Angelica
CNP
8010 Frost St Ste 510
San Diego, CA 92123
(858) 637-4700
Provider ID: 241988
License: RN521048
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Camargo-lowthers, Angelica
CNP
8010 Frost St Ste 510
San Diego, CA 92123
(858) 637-4700
Provider ID: 241988
License: NP14412
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Collinsworth, Jessica NP
5395 Ruffin Rd Ste 204
San Diego, CA 92123
(858) 571-3630
Provider ID: 259724
License: NP95008585
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mcgilloway, Melanie NP
3444 Kearny Villa Rd Ste 202
San Diego, CA 92123
(858) 429-7646
Provider ID: 269731
License: NP95013799
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Roh, Dongyon NP
5395 Ruffin Rd Ste 204
San Diego, CA 92123
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 375
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
(858) 571-3630
Provider ID: 259622
License: NP95004887
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Korean
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92127
Buckley, Patricia NP
16918 Dove Canyon Rd Ste
103
San Diego, CA 92127
(858) 649-5100
Provider ID: 279061
License: NP95015705
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92128
Moll, Jocelyn NP
11770 Bernardo Plaza Ct Ste
270
San Diego, CA 92128
(858) 485-0554
Provider ID: 276039
License: NP95010975
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92130
Kahl, Nicholas NP
12843 El Camino Real Ste 203
San Diego, CA 92130
(800) 926-8273
Provider ID: 269631
License: NP95006360
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Kovaleski, Natalia PA
Contract terminated as of
6/30/2021
12843 El Camino Real Ste 203
San Diego, CA 92130
(858) 554-1212
Provider ID: 269522
License: PA22994
Credentials and/or board
certification: No
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 376
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN MARCOS
92069
Buckley, Patricia NP
838 Nordahl Rd Ste 300
San Marcos, CA 92069
(760) 748-8935
Provider ID: 279059
License: NP95015705
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Coyle, Jennifer NP
838 Nordahl Rd Ste 300
San Marcos, CA 92069
(760) 748-8935
Provider ID: 279275
License: NP95006591
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN YSIDRO
92173
Balingit, Kat NP
4004 Beyer Blvd
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 265325
License: NP95012642
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Celiz, Adriana NP
3364 Beyer Blvd
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 269473
License: NP95004315
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Ching, Leyda NP
3364 Beyer Blvd Ste 102
San Ysidro, CA 92173
(619) 600-4867
Provider ID: 276588
License: NP20123
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 377
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Credentials and/or board PTA: No
certification: No Other Language: Spanish
Accepting New Members: Yes Driscoll, Susan NP Cultural Competency: NR
Hours: M-SA 9AM-5PM 4004 Beyer Blvd Accessibility: B; Members
PTA: No San Ysidro, CA 92173 should call the provider’s
Cultural Competency: NR (619) 662-4100 office to discuss their
Accessibility: B; Members Provider ID: 269504 accessibility needs when there
should call the provider’s License: NP95012943 is limited access or when
office to discuss their Credentials and/or board accessibility indicators are not
accessibility needs when there certification: No present.
is limited access or when Accepting New Members: Yes
accessibility indicators are not Hours: M-SA 9AM-5PM
present. PTA: No Hacinas, Reynaldo NP
Other Language: Spanish 4004 Beyer Blvd
Cultural Competency: NR San Ysidro, CA 92173
Da Cunha, Maria Luisa NP Accessibility: B; Members (619) 662-4100
3364 Beyer Blvd Ste 102 should call the provider’s Provider ID: 269582
San Ysidro, CA 92173 office to discuss their License: NP95003024
(619) 662-4100 accessibility needs when there Credentials and/or board
Provider ID: 270251 is limited access or when certification: No
License: NP95000200 accessibility indicators are not Accepting New Members: Yes
Credentials and/or board present. Hours: M-SA 9AM-5PM
certification: No PTA: No
Accepting New Members: Yes Cultural Competency: NR
Hours: M-SA 9AM-5PM Duran, Rebecca NP Accessibility: B; Members
PTA: No 3364 Beyer Blvd Ste 103 should call the provider’s
Cultural Competency: NR San Ysidro, CA 92173 office to discuss their
Accessibility: B; Members (619) 662-4100 accessibility needs when there
should call the provider’s Provider ID: 269571 is limited access or when
office to discuss their License: NP21054 accessibility indicators are not
accessibility needs when there Credentials and/or board present.
is limited access or when certification: No
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM Hurley, Teresa NP
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 378
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
4004 Beyer Blvd office to discuss their Credentials and/or board
San Ysidro, CA 92173 accessibility needs when there certification: No
(619) 662-4100 is limited access or when Accepting New Members: Yes
Provider ID: 253075 accessibility indicators are not Hours: M-SA 9AM-5PM
License: NP95012693 present. PTA: No
Credentials and/or board Other Language: Spanish
certification: No Cultural Competency: NR
Accepting New Members: Yes Lieber, Carol NP Accessibility: B; Members
Hours: M-SA 9AM-5PM 1601 Precision Park Ln should call the provider’s
PTA: No San Ysidro, CA 92173 office to discuss their
Cultural Competency: NR (619) 662-4100 accessibility needs when there
Accessibility: B; Members Provider ID: 253208 is limited access or when
should call the provider’s License: NP20849 accessibility indicators are not
office to discuss their Credentials and/or board present.
accessibility needs when there certification: No
is limited access or when Accepting New Members: Yes
accessibility indicators are not Hours: M-SA 9AM-5PM Nace, Michael NP
present. PTA: No 4004 Beyer Blvd
Cultural Competency: NR San Ysidro, CA 92173
Accessibility: B; Members (619) 662-4100
Lieber, Carol NP should call the provider’s Provider ID: 254731
4004 Beyer Blvd office to discuss their License: NP11492
San Ysidro, CA 92173 accessibility needs when there Credentials and/or board
(619) 662-4100 is limited access or when certification: No
Provider ID: 253207 accessibility indicators are not Accepting New Members: Yes
License: NP20849 present. Hours: M-SA 9AM-5PM
Credentials and/or board PTA: No
certification: No Cultural Competency: NR
Accepting New Members: Yes Martinez-sierra, Miguel NP Accessibility: B; Members
Hours: M-SA 9AM-5PM 3364 Beyer Blvd should call the provider’s
PTA: No San Ysidro, CA 92173 office to discuss their
Cultural Competency: NR (619) 662-4100 accessibility needs when there
Accessibility: B; Members Provider ID: 269472 is limited access or when
should call the provider’s License: NP95007913 accessibility indicators are not
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 379
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
present. PTA: No Chatham, Olivia NP
Rivera Beltran, Heriberto NP
4004 Beyer Blvd
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 269722
License: 95011671
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sanders, Jessica NP
4004 Beyer Blvd
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 253157
License: NP23004
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Shukla, Balwinder NP
3364 Beyer Blvd Ste 102
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 276623
License: NP95015232
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
VISTA
92083
950 Civic Center Dr Ste A
Vista, CA 92083
(760) 439-4839
Provider ID: 279263
License: NP95009164
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Certified Registered Nurse
Anesthetist
ENCINITAS
92024
King, April CRNA
700 Garden View Ct Ste 102
Encinitas, CA 92024
(760) 783-0441
Provider ID: 271544
License: NA2595
Credentials and/or board
certification: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 380
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Certified Registered Nurse
Midwife
SAN DIEGO
92105
Strauss, Joanna E CRNM
4060 Fairmount Ave
San Diego, CA 92105
(619) 255-9155
Provider ID: 279162
License: NM1920
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Clinical Neuropsychologist
CARLSBAD
92011
Alasantro, Lori PhD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 252909
License: PSY25817
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Quesnell, Tara DO
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 253082
License: 20A13609
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92029
Quesnell, Tara DO
1955 Citracado Pkwy Ste 102
Escondido, CA 92029
(760) 631-3000
Provider ID: 253083
License: 20A13609
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 381
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Kaup, Allison PhD
9850 Genesee Ave Ste 530
La Jolla, CA 92037
(760) 631-3000
Provider ID: 276986
License: PSY26484
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Kaup, Allison PhD
15611 Pomerado Rd Ste 505
Poway, CA 92064
(760) 631-3000
Provider ID: 253074
License: PSY26484
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dermatology
Dermatopathology
SAN DIEGO
92121
Erickson, Christopher MD
6605 Nancy Ridge Dr
San Diego, CA 92121
(858) 750-2983
Provider ID: 213891
License: A109927
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dermatology
CARLSBAD
92011
Brouha, Brook MD
6010 Hidden Valley Rd Ste 120
Carlsbad, CA 92011
(760) 884-5990
Provider ID: 272987
License: A97902
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 382
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
is limited access or when
accessibility indicators are not
present.
Special Expertise: HIV/AIDS
Riley, Jessica DO
6010 Hidden Valley Rd Ste 120
Carlsbad, CA 92011
(760) 884-5990
Provider ID: 265582
License: 20A16345
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CHULA VISTA
91910
Stein, Alexander MD
340 Fourth Ave Ste 14
Chula Vista, CA 91910
(619) 303-3681
Provider ID: 213494
License: A106295
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
Romanian
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Uebelhoer, Nathan DO
786 Third Ave Ste B
Chula Vista, CA 91910
(619) 425-0797
Provider ID: 265837
License: 20A9328
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
EL CAJON
92020
Celano, Nicholas MD
292 Avocado Ave
El Cajon, CA 92020
(619) 579-5115
Provider ID: 102191
License: A120411
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Chiang, Jennifer MD
292 Avocado Ave
El Cajon, CA 92020
(619) 579-5115
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 383
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Provider ID: 107659
License: A120528
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Chinese,
Mandarin, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Kassab, Ghada MD
330 S Magnolia Ave
El Cajon, CA 92020
(858) 273-2726
Provider ID: 245636
License: A114457
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Resh, William MD
292 Avocado Ave
El Cajon, CA 92020
(619) 579-5115
Provider ID: 127511
License: C34661
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sateesh, Brooke MD
292 Avocado Ave
El Cajon, CA 92020
(619) 579-5115
Provider ID: 269153
License: A109670
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ENCINITAS
92024
Gladsjo, Julie MD
477 N El Camino Real Ste D308
Encinitas, CA 92024
(760) 436-2300
Provider ID: 207589
License: A98641
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 384
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Brogan, Jacqueline MD
655 Euclid Ave Ste 401
National City, CA 91950
(619) 267-8303
Provider ID: 265495
License: A160890
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Cohen, Philip MD
655 Euclid Ave Ste 401
National City, CA 91950
(619) 267-8303
Provider ID: 202209
License: G89274
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Crowley, Christopher MD
655 Euclid Ave Ste 401
National City, CA 91950
(619) 267-8303
Provider ID: 241929
License: A134188
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Celano, Nicholas MD
655 Euclid Ave Ste 401
National City, CA 91950
(619) 267-8303
Provider ID: 102706
License: A120411
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Chiang, Jennifer MD
655 Euclid Ave Ste 401
National City, CA 91950
(619) 267-8303
Provider ID: 107662
License: A120528
Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 385
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Chinese,
Mandarin, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Nelson, Aislyn MD
655 Euclid Ave Ste 401
National City, CA 91950
(619) 267-8303
Provider ID: 242069
License: A147913
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Resh, William MD
655 Euclid Ave Ste 401
National City, CA 91950
(619) 267-8303
Provider ID: 204467
License: C34661
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sateesh, Brooke MD
655 Euclid Ave Ste 401
National City, CA 91950
(619) 267-8303
Provider ID: 127497
License: A109670
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Calame, Antoanella MD
15725 Pomerado Rd Ste 102
Poway, CA 92064
(858) 397-5755
Provider ID: 208891
License: A84455
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Romanian
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 386
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Uebelhoer, Nathan DO
15725 Pomerado Rd Ste 102
Poway, CA 92064
(858) 397-5755
Provider ID: 128022
License: 20A9328
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92103
Hamman, Michael MD
4060 4th Ave Ste 415
San Diego, CA 92103
(619) 298-9809
Provider ID: 208085
License: A97551
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hemperly, Stephen DO
4060 4th Ave Ste 415
San Diego, CA 92103
(619) 298-9809
Provider ID: 208070
License: 20A14658
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Reed, Kelly DO
4060 4th Ave Ste 415
San Diego, CA 92103
(619) 298-9809
Provider ID: 207628
License: 20A15550
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Shiell, Ronald MD
4060 4th Ave Ste 415
San Diego, CA 92103
(619) 289-9809
Provider ID: 207624
License: G70359
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 387
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Zaleski Larsen, Lisa DO
4060 4th Ave Ste 415
San Diego, CA 92103
(619) 298-9809
Provider ID: 208273
License: 20A13774
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92117
Kassab, Ghada MD
3737 Moraga Ave Ste A206
San Diego, CA 92117
(858) 273-2726
Provider ID: 245637
License: A114457
Credentials and/or board
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
certification: No
Accepting New Members: Yes
accessibility needs when there
is limited access or when
Hours: M-SA 9AM-5PM accessibility indicators are not
PTA: No
Other Language: Arabic,
present.
Spanish
Cultural Competency: NR Brouha, Brook MD
Accessibility: B; Members 9339 Genesee Ave Ste 350-a
should call the provider’s
office to discuss their
accessibility needs when there
San Diego, CA 92121
(858) 263-0571
Provider ID: 257317
is limited access or when License: A97902
accessibility indicators are not
present.
Credentials and/or board
certification: No
92121
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Boen, Monica MD
9339 Genesee Ave Ste 350
San Diego, CA 92121
(858) 454-4300
Provider ID: 207594
Other Language: French
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
License: A149554
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Special Expertise: HIV/AIDS
Other Language: French,
Polish, Spanish Tompkins, Stacy MD
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 388
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
9339 Genesee Ave Ste 350
San Diego, CA 92121
(858) 454-4300
Provider ID: 207967
License: A52958
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Uebelhoer, Nathan DO
6605 Nancy Ridge Dr
San Diego, CA 92121
(858) 900-2700
Provider ID: 128021
License: 20A9328
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92122
Keel, Douglas DO
8899 University Center Ln Ste
150
San Diego, CA 92122
(858) 535-1400
Provider ID: 127852
License: 20A7081
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92123
Nahm, Walter MD
7695 Cardinal Ct Ste 200
San Diego, CA 92123
(858) 278-8835
Provider ID: 241922
License: A78569
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Korean,
Spanish, Tagalog
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Diabetes Specialist
CHULA VISTA
91910
Argoud, Georges MD
340 Fourth Ave Ste 7a
Chula Vista, CA 91910
(619) 691-0388
Provider ID: 217420
License: G61898
Credentials and/or board
certification: No
Accepting New Members: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 389
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Emergency Medicine
Alcalde, Victor MD
333 H St Ste 2080
Chula Vista, CA 91910
(619) 662-4100
Provider ID: 276253
License: A170657
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Carstairs, Shaun MD
333 H St Ste 2080
Chula Vista, CA 91910
(619) 662-4100
Provider ID: 276248
License: A71434
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dillman, Ariana MD
333 H St Ste 2080
Chula Vista, CA 91910
(619) 662-4100
Provider ID: 276244
License: A118150
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Einstein, Eric MD
333 H St Ste 2080
Chula Vista, CA 91910
(619) 662-4100
Provider ID: 276249
License: A134524
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
French, Tonianne MD
333 H St Ste 2080
Chula Vista, CA 91910
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 390
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
(619) 662-4100
Provider ID: 276170
License: G74840
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Galasso, Madison MD
333 H St Ste 2080
Chula Vista, CA 91910
(619) 662-4100
Provider ID: 276243
License: A160982
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Griesinger, Michael MD
333 H St Ste 2080
Chula Vista, CA 91910
(619) 662-4100
Provider ID: 276222
License: A155029
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Jost, Peter MD
333 H St Ste 2080
Chula Vista, CA 91910
(619) 662-4100
Provider ID: 276191
License: A81661
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Kornblatt, Allison MD
333 H St Ste 2080
Chula Vista, CA 91910
(619) 662-4100
Provider ID: 276192
License: A158412
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 391
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Lopez, Jason MD should call the provider’s License: 20A10015
333 H St Ste 2080 office to discuss their Credentials and/or board
Chula Vista, CA 91910 accessibility needs when there certification: No
(619) 662-4100 is limited access or when Accepting New Members: Yes
Provider ID: 276186 accessibility indicators are not Hours: M-SA 9AM-5PM
License: A155935 present. PTA: No
Credentials and/or board Cultural Competency: NR
certification: No Accessibility: B; Members
Accepting New Members: Yes Quenzer, Faith DO should call the provider’s
Hours: M-SA 9AM-5PM 333 H St Ste 2080 office to discuss their
PTA: No Chula Vista, CA 91910 accessibility needs when there
Cultural Competency: NR (619) 662-4100 is limited access or when
Accessibility: B; Members Provider ID: 276194 accessibility indicators are not
should call the provider’s License: 20A15401 present.
office to discuss their Credentials and/or board
accessibility needs when there certification: No
is limited access or when Accepting New Members: Yes Riccoboni, Steven MD
accessibility indicators are not Hours: M-SA 9AM-5PM 333 H St Ste 2080
present. PTA: No Chula Vista, CA 91910
Cultural Competency: NR (619) 662-4100
Accessibility: B; Members Provider ID: 276232
Portillo, Tania MD should call the provider’s License: A133402
333 H St Ste 2080 office to discuss their Credentials and/or board
Chula Vista, CA 91910 accessibility needs when there certification: No
(619) 662-4100 is limited access or when Accepting New Members: Yes
Provider ID: 276207 accessibility indicators are not Hours: M-SA 9AM-5PM
License: A141013 present. PTA: No
Credentials and/or board Other Language: Italian
certification: No Cultural Competency: NR
Accepting New Members: Yes Reardon, Jacqueline DO Accessibility: B; Members
Hours: M-SA 9AM-5PM 333 H St Ste 2080 should call the provider’s
PTA: No Chula Vista, CA 91910 office to discuss their
Cultural Competency: NR (619) 662-4100 accessibility needs when there
Accessibility: B; Members Provider ID: 276235 is limited access or when
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 392
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
accessibility indicators are not
present.
Roxas, Roger MD
333 H St Ste 2080
Chula Vista, CA 91910
(619) 662-4100
Provider ID: 276190
License: A166981
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Steiner, Brian MD
333 H St Ste 2080
Chula Vista, CA 91910
(619) 662-4100
Provider ID: 276187
License: A155350
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Tovar, Juan MD
333 H St Ste 2080
Chula Vista, CA 91910
(619) 662-4100
Provider ID: 276195
License: A72609
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Mizzell, Joseph MD
9850 Genesee Ave Ste 370
La Jolla, CA 92037
(858) 625-7200
Provider ID: 265327
License: A111893
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92130
Jurkowski, Leonard MD
3830 Valley Centre Dr Ste 702
San Diego, CA 92130
(858) 720-0554
Provider ID: 127825
License: C43217
Credentials and/or board
certification: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 393
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Endocrinology Metabolism
CHULA VISTA
91910
Philis-tsimikas, Athena MD
678 Third Ave
Chula Vista, CA 91910
(619) 662-4100
Provider ID: 265350
License: A50477
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Greek
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Endocrinology
Vincent, Lauren MD
678 Third Ave
Chula Vista, CA 91910
(619) 662-4100
Provider ID: 265472
License: A134303
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Gastroenterology
Alayo, Erick MD
587 Third Ave
Chula Vista, CA 91910
(619) 382-3315
Provider ID: 43530
License: A107506
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Wiener, Gregory MD
353 Church Ave # A
Chula Vista, CA 91910
(619) 585-8883
Provider ID: 207348
License: A41749
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: French,
Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 394
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CORONADO
92118
Hassanein, Tarek MD
131 Orange Ave Ste 101b
Coronado, CA 92118
(619) 522-0399
Provider ID: 276939
License: A54452
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
French, German, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
EL CAJON
92019
Gish, Robert MD
165 S 1st St
El Cajon, CA 92019
(619) 312-0347
Provider ID: 279968
License: G45632
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Dutch,
French, Spanish, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92020
Hassanein, Tarek MD
463 N Magnolia Ave
El Cajon, CA 92020
(619) 522-0399
Provider ID: 276938
License: A54452
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
French, German, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92021
Gish, Robert MD
1032 Broadway
El Cajon, CA 92021
(619) 795-5991
Provider ID: 279967
License: G45632
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Dutch,
French, Spanish, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 395
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
present. certification: Yes present.
ENCINITAS
92024
Ally, Mazer MD
477 N El Camino Real Ste A308
Encinitas, CA 92024
(760) 436-8881
Provider ID: 269064
License: A146924
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dilauro, Steven MD
700 Garden View Ct Ste 102
Encinitas, CA 92024
(760) 783-0441
Provider ID: 257122
License: A104332
Credentials and/or board
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Goldklang, Robert MD
700 Garden View Ct Ste 102
Encinitas, CA 92024
(760) 783-0441
Provider ID: 66037
License: G69237
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
Lajoie, Adrianne MD
700 Garden View Ct Ste 102
Encinitas, CA 92024
(760) 783-0441
Provider ID: 257124
License: A84301
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Singh, Marvin MD
320 Santa Fe Dr Ste 308
Encinitas, CA 92024
(760) 783-0441
Provider ID: 260237
License: A102749
Credentials and/or board
certification: No
Accepting New Members: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 396
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Korean,
Russian, Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Mayer, Andrew MD
9850 Genesee Ave Ste 820
La Jolla, CA 92037
(858) 453-5200
Provider ID: 65728
License: A77759
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Paredez, Edward MD
9850 Genesee Ave Ste 820
La Jolla, CA 92037
(858) 453-5200
Provider ID: 65734
License: A87900
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Gish, Robert MD
217 Highland Ave
National City, CA 91950
(619) 434-7308
Provider ID: 279969
License: G45632
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Dutch,
French, Spanish, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
OCEANSIDE
92056
Devereaux, Christopher MD
3923 Waring Rd Ste A
Oceanside, CA 92056
(760) 724-8782
Provider ID: 259620
License: G75223
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 397
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Krol, Thomas MD
3923 Waring Rd Ste A
Oceanside, CA 92056
(760) 724-8782
Provider ID: 259634
License: G43649
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Shad, Javaid MD
3923 Waring Rd Ste A
Oceanside, CA 92056
(760) 724-8782
Provider ID: 259610
License: G86962
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Hindi, Urdu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Shim, Michael MD
3923 Waring Rd Ste A
Oceanside, CA 92056
(760) 724-8782
Provider ID: 259633
License: A88942
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Viernes, Matthew MD
3923 Waring Rd Ste A
Oceanside, CA 92056
(760) 724-8782
Provider ID: 259638
License: A61516
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92105
Gish, Robert MD
4060 Fairmount Ave
San Diego, CA 92105
(619) 779-7900
Provider ID: 279965
License: G45632
Credentials and/or board
certification: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 398
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Dutch,
French, Spanish, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Gish, Robert MD
4171 Fairmount Ave
San Diego, CA 92105
(619) 269-1269
Provider ID: 279966
License: G45632
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Dutch,
French, Spanish, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hearing Aid Dealer / Supplier
CARLSBAD
92008
Davis, Kelle MA
1820 Marron Rd
Carlsbad, CA 92008
(760) 434-0125
Provider ID: 253149
License: HA6083
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Wyman, Wendy MA
1820 Marron Rd Ste 102
Carlsbad, CA 92008
(760) 434-0125
Provider ID: 252978
License: HA8365
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CHULA VISTA
91910
Anderson, Elaine MA
310 Third Ave Ste B21/c11
Chula Vista, CA 91910
(619) 426-0841
Provider ID: 253459
License: HA7100
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 399
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
is limited access or when
accessibility indicators are not
present.
EL CAJON
92021
Dandurand, John MA
1767 E Main St
El Cajon, CA 92021
(619) 440-6516
Provider ID: 252964
License: HA2056
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Davis, Kelle MA
1767 E Main St
El Cajon, CA 92021
(619) 440-6516
Provider ID: 253148
License: HA6083
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Wyman, Wendy MA
330 W Felicita Ave Ste A4
Escondido, CA 92025
(858) 259-4182
Provider ID: 252976
License: HA8365
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92120
Anderson, Elaine MA
6367 Alvarado Ct
San Diego, CA 92120
(619) 583-7002
Provider ID: 252907
License: HA7100
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dandurand, John MA
6367 Alvarado Ct
San Diego, CA 92120
(858) 259-4182
Provider ID: 252965
License: HA2056
Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 400
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92123
Anaya, Manuel MA
9340 Clairemont Mesa Blvd Ste
D
San Diego, CA 92123
(858) 278-9911
Provider ID: 265704
License: HA8368
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Davis, Kelle MA
9340 Clairemont Mesa Blvd
San Diego, CA 92123
(760) 434-0125
Provider ID: 253150
License: HA6083
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SOLANA BEACH
92075
Dandurand, John MA
740 Lomas Santa Fe Dr Ste 110
Solana Beach, CA 92075
(858) 259-4182
Provider ID: 252963
License: HA2056
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Wyman, Wendy MA
740 Lomas Santa Fe Dr Ste 110
Solana Beach, CA 92075
(858) 259-4182
Provider ID: 252977
License: HA8365
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 401
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Hematology / Oncology
LA JOLLA
92037
Banerjee, Pushpendu MD
9850 Genesee Ave Ste 560
La Jolla, CA 92037
(858) 552-1410
Provider ID: 54041
License: A69490
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Hindi
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sinclair, James MD
9850 Genesee Ave Ste 560
La Jolla, CA 92037
(858) 552-1410
Provider ID: 54027
License: G48926
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Wallach, Sabina MD
9850 Genesee Ave Ste 400
La Jolla, CA 92037
(858) 558-8666
Provider ID: 65743
License: A34070
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: French,
Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
OCEANSIDE
92056
Siddique, Nayyar MD
3617 Vista Way
Oceanside, CA 92056
(760) 758-5770
Provider ID: 274776
License: A62744
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Urdu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Singh, Himani MD
3617 Vista Way
Oceanside, CA 92056
(760) 758-5770
Provider ID: 272698
License: A143620
Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 402
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Infectious Disease
LA JOLLA
92037
Barthel, Robert MD
9850 Genesee Ave Ste 900
La Jolla, CA 92037
(858) 626-7780
Provider ID: 212799
License: C55858
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Miller, Howard MD
9834 Genesee Ave Ste 310
La Jolla, CA 92037
(858) 457-8600
Provider ID: 273257
License: C38875
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Internal Medicine Critical
Care Medicine
ENCINITAS
92024
Smilde, Renee MD
662 Encinitas Blvd Ste 220
Encinitas, CA 92024
(833) 446-6363
Provider ID: 271804
License: A70175
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Dutch
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Shin, Stephanie MD
320 Santa Fe Dr Ste 107-c
Encinitas, CA 92024
(760) 230-8994
Provider ID: 260072
License: A130231
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 403
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Tran, Sheri MD
320 Santa Fe Dr Ste 107c
Encinitas, CA 92024
(760) 230-8994
Provider ID: 270757
License: A124071
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Jones, Daniel MD
9850 Genesee Ave Ste 780
La Jolla, CA 92037
(858) 625-7200
Provider ID: 244322
License: A102945
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92103
Bencheqroun, Hassan MD
501 Washington St Ste 735
San Diego, CA 92103
(760) 618-1353
Provider ID: 238851
License: A112435
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
French, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Internal Medicine
CHULA VISTA
91910
Al-kourainy, Kousay MD
480 4th Ave Ste 409
Chula Vista, CA 91910
(619) 425-2080
Provider ID: 269224
License: A39783
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic,
Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 404
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
is limited access or when
accessibility indicators are not
present.
Duque, John MD
480 4th Ave Ste 316
Chula Vista, CA 91910
(619) 691-0240
Provider ID: 244807
License: G48442
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Gollapudi, Raghava MD
450 Fourth Ave Ste 215
Chula Vista, CA 91910
(858) 244-6870
Provider ID: 221390
License: A73392
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Gurudevan, Swaminatha MD
321 E St
Chula Vista, CA 91910
(619) 934-3260
Provider ID: 259771
License: A70212
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Hindi,
Spanish, Tamil
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hassanein, Tarek MD
303 H St Ste 103
Chula Vista, CA 91910
(619) 522-0399
Provider ID: 279359
License: A54452
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
French, German, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Iturbe-alessio, Ignacio MD
480 4th Ave Ste 409
Chula Vista, CA 91910
(619) 425-2080
Provider ID: 270498
License: A42415
Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 405
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
certification: Yes accessibility indicators are not certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Johnson, Mark MD
480 4th Ave Ste 506
Chula Vista, CA 91910
(619) 585-0313
Provider ID: 257518
License: G28163
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
present.
Moolani, Ramesh MD
480 Fourth Ave Ste 409
Chula Vista, CA 91910
(619) 425-2080
Provider ID: 269218
License: C149851
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: German,
Gujarati, Sindhi
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Ponce, Sonia MD
450 Fourth Ave Ste 215
Chula Vista, CA 91910
(619) 434-0204
Provider ID: 212809
License: A145008
Credentials and/or board
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
91911
Carlson, Steven MD
765 Medical Center Ct Ste 211
Chula Vista, CA 91911
(619) 616-2100
Provider ID: 238127
License: A109957
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 406
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
accessibility indicators are not
present.
Mohamedali, Burhan MD
765 Medical Center Ct Ste 211
Chula Vista, CA 91911
(619) 616-2100
Provider ID: 238120
License: A125669
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Swahili
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Narayanan, Meena MD
765 Medical Center Ct Ste 211
Chula Vista, CA 91911
(619) 616-2100
Provider ID: 238132
License: A113448
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Parikh, Milind DO
765 Medical Center Ct Ste 211
Chula Vista, CA 91911
(619) 616-2100
Provider ID: 238194
License: 20A13745
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rutledge, Michael MD
765 Medical Center Ct Ste 211
Chula Vista, CA 91911
(619) 616-2100
Provider ID: 257159
License: C166106
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
91914
Narula, Arvin MD
890 Eastlake Pkwy Ste 205
Chula Vista, CA 91914
(858) 244-6800
Provider ID: 246870
License: A125186
Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 407
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
certification: No accessibility indicators are not certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
EL CAJON
92020
Ponce, Sonia MD
328 Highland Ave Ste 200
El Cajon, CA 92020
(619) 930-9404
Provider ID: 212810
License: A145008
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM
92021 PTA: No
Other Language: Spanish,
Carlson, Steven MD Swahili
1625 E Main St Ste 201 Cultural Competency: NR
El Cajon, CA 92021 Accessibility: B; Members
(619) 486-6512 should call the provider’s
Provider ID: 248317 office to discuss their
License: A109957 accessibility needs when there
Credentials and/or board is limited access or when
certification: No accessibility indicators are not
Accepting New Members: Yes present.
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish Narayanan, Meena MD
Cultural Competency: NR 1625 E Main St Ste 201
Accessibility: B; Members El Cajon, CA 92021
should call the provider’s (619) 486-6512
office to discuss their Provider ID: 248192
accessibility needs when there License: A113448
is limited access or when Credentials and/or board
accessibility indicators are not certification: No
present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Mohamedali, Burhan MD Other Language: Farsi,
1625 E Main St Ste 201 Spanish
El Cajon, CA 92021 Cultural Competency: NR
(619) 486-6512 Accessibility: B; Members
Provider ID: 248119 should call the provider’s
License: A125669 office to discuss their
Credentials and/or board accessibility needs when there
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 408
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
is limited access or when
accessibility indicators are not
present.
Rutledge, Michael MD
1625 E Main St Ste 201
El Cajon, CA 92021
(619) 486-6512
Provider ID: 278840
License: C166106
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ENCINITAS
92024
Bulibek, Batyrjan MD
320 Santa Fe Dr Ste 204
Encinitas, CA 92024
(760) 944-7300
Provider ID: 265216
License: A148198
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Patel, Janki MD
700 Garden View Ct Ste 102
Encinitas, CA 92024
(760) 783-0441
Provider ID: 257158
License: A133101
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Seeger, Kristina MD
477 N El Camino Real Ste A308
Encinitas, CA 92024
(760) 436-8881
Provider ID: 269058
License: A136185
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sullivan, Jessica DO
326 Santa Fe Dr Ste 105
Encinitas, CA 92024
(760) 452-3340
Provider ID: 273554
License: 20A16273
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 409
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Singh, Marvin MD
700 Garden View Ct Ste 102
Encinitas, CA 92024
(760) 783-0441
Provider ID: 257154
License: A102749
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Korean,
Russian, Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Carlson, Steven MD
488 E Valley Pkwy Ste 107
Escondido, CA 92025
(760) 294-0480
Provider ID: 278818
License: A109957
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mohamedali, Burhan MD
488 E Valley Pkwy Ste 107
Escondido, CA 92025
(760) 294-0480
Provider ID: 278841
License: A125669
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Swahili
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Narayanan, Meena MD
488 E Valley Pkwy Ste 107
Escondido, CA 92025
(760) 294-0480
Provider ID: 278830
License: A113448
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 410
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
present. Hours: M-SA 9AM-5PM present.
Parikh, Milind DO
488 E Valley Pkwy Ste 107
Escondido, CA 92025
(619) 486-6512
Provider ID: 278814
License: 20A13745
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rutledge, Michael MD
488 E Valley Pkwy Ste 107
Escondido, CA 92025
(760) 294-0480
Provider ID: 278838
License: C166106
Credentials and/or board
certification: No
Accepting New Members: Yes
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
FALLBROOK
92028
Hong, John MD
521 E Elder St Ste 104
Fallbrook, CA 92028
(760) 728-9560
Provider ID: 269014
License: A63582
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Korean
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
LA JOLLA
92037
Buchbinder, Maurice MD
9850 Genesee Ave Ste 780
La Jolla, CA 92037
(858) 824-2900
Provider ID: 257957
License: A38176
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Charlat, Martin MD
9834 Genesee Ave Ste 300
La Jolla, CA 92037
(858) 824-2900
Provider ID: 265336
License: G64921
Credentials and/or board
certification: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 411
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Accepting New Members: Yes Other Language: Hindi,
Hours: M-SA 9AM-5PM Spanish, Tamil
PTA: No Damani, Samir MD Cultural Competency: NR
Other Language: French 9850 Genesee Ave Ste 650 Accessibility: B; Members
Cultural Competency: NR La Jolla, CA 92037 should call the provider’s
Accessibility: B; Members (858) 800-2480 office to discuss their
should call the provider’s Provider ID: 275125 accessibility needs when there
office to discuss their License: A88989 is limited access or when
accessibility needs when there Credentials and/or board accessibility indicators are not
is limited access or when certification: No present.
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM
PTA: No Harrington, John MD
Cultural Competency: NR 9850 Genesee Ave Ste 780
Charlat, Martin MD Accessibility: B; Members La Jolla, CA 92037
9850 Genesee Ave Ste 780 should call the provider’s (858) 450-3388
La Jolla, CA 92037 office to discuss their Provider ID: 252957
(858) 824-2900 accessibility needs when there License: A45573
Provider ID: 272332 is limited access or when Credentials and/or board
License: G64921 accessibility indicators are not certification: No
Credentials and/or board present. Accepting New Members: Yes
certification: No Hours: M-SA 9AM-5PM
Accepting New Members: Yes PTA: No
Hours: M-SA 9AM-5PM Gurudevan, Swaminatha MD Cultural Competency: NR
PTA: No 9834 Genesee Ave Ste 101 Accessibility: B; Members
Other Language: French La Jolla, CA 92037 should call the provider’s
Cultural Competency: NR (858) 430-8455 office to discuss their
Accessibility: B; Members Provider ID: 259770 accessibility needs when there
should call the provider’s License: A70212 is limited access or when
office to discuss their Credentials and/or board accessibility indicators are not
accessibility needs when there certification: No present.
is limited access or when Accepting New Members: Yes
accessibility indicators are not Hours: M-SA 9AM-5PM
present. PTA: No Hong, Eric MD
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 412
115
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
9850 Genesee Ave Ste 780
La Jolla, CA 92037
(858) 824-2900
Provider ID: 272353
License: A101767
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Boghairi, Anoushiravan MD
5565 Grossmont Center Dr Ste
La Mesa, CA 91942
(619) 698-6667
Provider ID: 210579
License: A33832
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Persian
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Razi, Bijan MD
8851 Center Dr Ste 405
La Mesa, CA 91942
(619) 265-0200
Provider ID: 238787
License: A37882
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Reddy, Reddiwandla MD
5565 Grossmont Center Dr Ste
202
La Mesa, CA 91942
(619) 461-6130
Provider ID: 265392
License: A38098
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Kannada,
Spanish, Telugu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Esfahani, Fatemeh MD
655 Euclid Ave Ste 304
National City, CA 91950
(619) 470-7700
Provider ID: 241971
License: A126659
Credentials and/or board
certification: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 413
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Persian
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
OCEANSIDE
92056
Chiao, Hellen MD
3923 Waring Rd Ste A
Oceanside, CA 92056
(760) 724-8782
Provider ID: 259685
License: A127722
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Cantonese,
Mandarin, Spanish,
Taiwanese, Yue Chinese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92103
Chung, Kiyon MD
4060 4th Ave Ste 650
San Diego, CA 92103
(619) 819-7222
Provider ID: 246315
License: C54514
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Korean
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Friedman, Richard MD
4060 4th Ave Ste 650
San Diego, CA 92103
(619) 819-7222
Provider ID: 246324
License: G32430
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92114
Carlson, Steven MD
292 Euclid Ave Ste 210
San Diego, CA 92114
(619) 616-2100
Provider ID: 238128
License: A109957
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 414
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
office to discuss their Provider ID: 238133 office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mohamedali, Burhan MD
292 Euclid Ave Ste 210
San Diego, CA 92114
(619) 616-2100
Provider ID: 238121
License: A125669
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Swahili
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Narayanan, Meena MD
292 Euclid Ave Ste 210
San Diego, CA 92114
(619) 616-2100
License: A113448
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Parikh, Milind DO
292 Euclid Ave Ste 210
San Diego, CA 92114
(619) 616-2100
Provider ID: 238195
License: 20A13745
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rutledge, Michael MD
292 Euclid Ave Ste 210
San Diego, CA 92114
(619) 616-2100
Provider ID: 257160
License: C166106
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92123
Gollapudi, Raghava MD
3131 Berger Ave Ste 200
San Diego, CA 92123
(858) 244-6800
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 415
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Provider ID: 221389
License: A73392
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Narula, Arvin MD
3131 Berger Ave Ste 200
San Diego, CA 92123
(858) 244-6800
Provider ID: 218622
License: A125186
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN MARCOS
92078
Carlson, Steven MD
955 Boardwalk Ste 100
San Marcos, CA 92078
(760) 798-8855
Provider ID: 238129
License: A109957
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mohamedali, Burhan MD
955 Boardwalk Ste 100
San Marcos, CA 92078
(760) 798-8855
Provider ID: 238122
License: A125669
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Swahili
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Narayanan, Meena MD
955 Boardwalk Ste 100
San Marcos, CA 92078
(760) 798-8855
Provider ID: 238134
License: A113448
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 416
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Rutledge, Michael MD
955 Boardwalk Ste 100
San Marcos, CA 92078
(760) 798-8855
Provider ID: 278839
License: C166106
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Interventional Cardiology
EL CAJON
92020
Omran, Jad MD
300 S Pierce St Ste 102
El Cajon, CA 92020
(619) 668-4700
Provider ID: 241942
License: A144651
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ENCINITAS
92024
Yturralde, Frederick MD
700 Garden View Ct Ste 204
Encinitas, CA 92024
(760) 452-6334
Provider ID: 276086
License: C168384
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Yturralde, Frederick MD
354 Santa Fe Dr
Encinitas, CA 92024
(760) 452-6334
Provider ID: 276087
License: C168384
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Rapeport, Kevin MD
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 417
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
9850 Genesee Ave Ste 940b
La Jolla, CA 92037
(858) 864-1400
Provider ID: 265292
License: A43603
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Maternal and Fetal Medicine
EL CAJON
92019
Faksh, Arij DO
165 S 1st St
El Cajon, CA 92019
(619) 312-0347
Provider ID: 278441
License: 20A14222
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92021
Faksh, Arij DO
1032 Broadway
El Cajon, CA 92021
(619) 795-5991
Provider ID: 278442
License: 20A14222
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Faksh, Arij DO
217 Highland Ave
National City, CA 91950
(619) 434-7308
Provider ID: 278443
License: 20A14222
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92105
Faksh, Arij DO
4060 Fairmount Ave
San Diego, CA 92105
(619) 280-7072
Provider ID: 278440
License: 20A14222
Credentials and/or board
certification: No
Accepting New Members: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 418
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92130
Ahn, Jennifer MD
12264 El Camino Real Ste 204
San Diego, CA 92130
(858) 794-7700
Provider ID: 273140
License: C160026
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Dowling, David MD
12264 El Camino Real Ste 204
San Diego, CA 92130
(858) 794-7700
Provider ID: 127779
License: G80714
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Gollin, Yvonne MD
12264 El Camino Real Ste 204
San Diego, CA 92130
(858) 794-7700
Provider ID: 127801
License: G85078
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Medical Oncology
OCEANSIDE
92056
Paroly, Warren MD
3617 Vista Way
Oceanside, CA 92056
(760) 758-5770
Provider ID: 272516
License: G29867
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 419
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
SAN MARCOS
92069
Kosmo, Michael MD
838 Nordahl Rd Ste 300
San Marcos, CA 92069
(760) 747-8935
Provider ID: 53701
License: G54074
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
German, Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Nephrology
CHULA VISTA
91910
Bedoya, Luis MD
340 4th Ave Ste 4
Chula Vista, CA 91910
(619) 427-1144
Provider ID: 210600
License: A51105
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Horeish, Adam MD
340 4th Ave Ste 4
Chula Vista, CA 91910
(619) 427-1144
Provider ID: 210543
License: C56089
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Khaing, Kathy MD
340 4th Ave Ste 4
Chula Vista, CA 91910
(619) 427-1144
Provider ID: 210574
License: A127006
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Burmese,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Lozada-pastorio, Elizabeth MD
340 4th Ave Ste 4
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 420
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Chula Vista, CA 91910 should call the provider’s Provider ID: 213987
(619) 427-1144 office to discuss their License: A68995
Provider ID: 212909 accessibility needs when there Credentials and/or board
License: A90108 is limited access or when certification: Yes
Credentials and/or board accessibility indicators are not Accepting New Members: Yes
certification: No present. Hours: M-SA 9AM-5PM
Accepting New Members: Yes PTA: Yes
Hours: M-SA 9AM-5PM Other Language: Spanish
PTA: Yes Patel, Amar MD Cultural Competency: NR
Other Language: Spanish 340 Fourth Ave Ste 4 Accessibility: B; Members
Cultural Competency: NR Chula Vista, CA 91910 should call the provider’s
Accessibility: B; Members (858) 810-8000 office to discuss their
should call the provider’s Provider ID: 245184 accessibility needs when there
office to discuss their License: A158295 is limited access or when
accessibility needs when there Credentials and/or board accessibility indicators are not
is limited access or when certification: No present.
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM
PTA: No Thomas, Theodore MD
Other Language: Gujarati Contract terminated as of
Meyer, Jill MD Cultural Competency: NR 8/31/2021
340 4th Ave Ste 4 Accessibility: B; Members 786 Third Ave Ste B
Chula Vista, CA 91910 should call the provider’s Chula Vista, CA 91910
(619) 427-1144 office to discuss their (619) 425-0797
Provider ID: 212814 accessibility needs when there Provider ID: 263217
License: A95882 is limited access or when License: G61681
Credentials and/or board accessibility indicators are not Credentials and/or board
certification: Yes present. certification: No
Accepting New Members: Yes Accepting New Members: No
Hours: M-SA 9AM-5PM Hours: M-SA 9AM-5PM
PTA: Yes Soltero, Ricardo MD PTA: No
Other Language: Spanish 340 4th Ave Ste 4 Other Language: Spanish
Cultural Competency: NR Chula Vista, CA 91910 Cultural Competency: NR
Accessibility: B, W; Members (619) 427-1144 Accessibility: B; Members
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 421
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
should call the provider’s (619) 425-0797 Accessibility: B; Members
office to discuss their Provider ID: 265229 should call the provider’s
accessibility needs when there License: A49216 office to discuss their
is limited access or when Credentials and/or board accessibility needs when there
accessibility indicators are not certification: No is limited access or when
present. Accepting New Members: Yes accessibility indicators are not
Hours: M-SA 9AM-5PM present.
PTA: No
Videen, John MD Other Language: Spanish,
786 Third Ave Ste B Tamil Meyer, Jill MD
Chula Vista, CA 91910 Cultural Competency: NR 752 Medical Center Ct Ste 302
(619) 425-0797 Accessibility: B; Members Chula Vista, CA 91911
Provider ID: 265266 should call the provider’s (619) 421-3361
License: G59271 office to discuss their Provider ID: 212815
Credentials and/or board accessibility needs when there License: A95882
certification: No is limited access or when Credentials and/or board
Accepting New Members: Yes accessibility indicators are not certification: No
Hours: M-SA 9AM-5PM present. Accepting New Members: Yes
PTA: No Hours: M-SA 9AM-5PM
Other Language: Spanish 91911 PTA: No
Cultural Competency: NR Other Language: Spanish
Accessibility: B; Members Lozada-pastorio, Elizabeth MD Cultural Competency: NR
should call the provider’s 752 Medical Center Ct Ste 302 Accessibility: B; Members
office to discuss their Chula Vista, CA 91911 should call the provider’s
accessibility needs when there (619) 421-3361 office to discuss their
is limited access or when Provider ID: 212910 accessibility needs when there
accessibility indicators are not License: A90108 is limited access or when
present. Credentials and/or board accessibility indicators are not
certification: No present.
Accepting New Members: Yes
Wijeyakumar, Vijayalakshmi Hours: M-SA 9AM-5PM
MD PTA: No Videen, John MD
786 Third Ave Ste B Other Language: Spanish 752 Medical Center Ct Ste 302
Chula Vista, CA 91910 Cultural Competency: NR Chula Vista, CA 91911
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 422
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
(619) 421-3361
Provider ID: 212802
License: G59271
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Vyas, Dhwanil MD
752 Medical Center Ct Ste 302
Chula Vista, CA 91911
(619) 421-3361
Provider ID: 210420
License: A125364
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Gujarati,
Hindi, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
91914
Gollapudi, Raghava MD
890 Eastlake Pkwy Ste 205
Chula Vista, CA 91914
(858) 244-6800
Provider ID: 246813
License: A73392
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CORONADO
92118
Hammes, John MD
230 Prospect Pl Ste 340b
Coronado, CA 92118
(619) 299-2350
Provider ID: 214242
License: G84351
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ENCINITAS
92024
Lakhera, Yogita MD
320 Santa Fe Dr Ste 212
Encinitas, CA 92024
(760) 509-1040
Provider ID: 109347
License: A125173
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 423
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
PTA: No certification: No
Other Language: Hindi
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Greenstein, Joshua MD
631 E Grand Ave
Escondido, CA 92025
(760) 294-1660
Provider ID: 53809
License: A68100
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hebreo, Joseph MD
631 E Grand Ave
Escondido, CA 92025
(760) 294-1660
Provider ID: 108435
License: A93436
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Kayal, Anas MD
Contract terminated as of
6/30/2021
631 E Grand Ave
Escondido, CA 92025
(760) 294-1660
Provider ID: 82436
License: A112450
Credentials and/or board
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Khawar, Osman MD
631 E Grand Ave
Escondido, CA 92025
(760) 294-1660
Provider ID: 53715
License: A92165
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Urdu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 424
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
accessibility indicators are not certification: No office to discuss their
present.
Neyaz, Mohammed DO
631 E Grand Ave
Escondido, CA 92025
(760) 294-1660
Provider ID: 108420
License: 20A13534
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Hindi,
Spanish, Urdu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Shapiro, Mark MD
631 E Grand Ave
Escondido, CA 92025
(760) 294-1660
Provider ID: 54458
License: G65280
Credentials and/or board
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Swahili
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Boiskin, Mark MD
9834 Genesee Ave Ste 312
La Jolla, CA 92037
(858) 558-8150
Provider ID: 40762
License: A52055
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Afrikaans,
Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Comunale, Roderick MD
6501 La Jolla Blvd
La Jolla, CA 92037
(858) 551-0276
Provider ID: 270592
License: A43885
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Friend, Peter MD
9850 Genesee Ave Ste 420
La Jolla, CA 92037
(858) 453-9460
Provider ID: 54226
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 425
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
License: G22253
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Steer, Dylan MD
9834 Genesee Ave Ste 312
La Jolla, CA 92037
(858) 558-8150
Provider ID: 31399
License: A65604
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Torosian, Karo DO
9834 Genesee Ave Ste 312
La Jolla, CA 92037
(858) 558-8150
Provider ID: 118749
License: 20A12445
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Armenian,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Do, Luan MD
8851 Center Dr Ste 505
La Mesa, CA 91942
(619) 461-3880
Provider ID: 213088
License: A65161
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Fadda, George MD
8851 Center Dr Ste 505
La Mesa, CA 91942
(619) 461-3880
Provider ID: 241957
License: A44918
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
French
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 426
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
accessibility needs when there License: G83902 office to discuss their
is limited access or when
accessibility indicators are not
present.
Miller, Lucy MD
8851 Center Dr Ste 505
La Mesa, CA 91942
(619) 461-3880
Provider ID: 212712
License: A53843
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Japanese,
Portuguese, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Thompson, John MD
8851 Center Dr Ste 505
La Mesa, CA 91942
(619) 461-3880
Provider ID: 214255
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Comunale, Roderick MD
502 Euclid Ave Ste 205
National City, CA 91950
(858) 551-0276
Provider ID: 270591
License: A43885
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Calderon Molina, Juan MD
655 Euclid Ave Ste 303
National City, CA 91950
(619) 585-4370
Provider ID: 213112
License: C143845
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: German,
Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Maa Chip, Fharak MD
655 Euclid Ave Ste 303
National City, CA 91950
(619) 475-4900
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 427
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Provider ID: 212900
License: A117604
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sacamay, Tagumpay MD
655 Euclid Ave Ste 303
National City, CA 91950
(619) 475-4900
Provider ID: 212753
License: A62631
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
OCEANSIDE
92056
Barager, Richard MD
3300 Vista Way Ste B
Oceanside, CA 92056
(760) 967-9900
Provider ID: 39437
License: G52074
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Kyaw, Naing MD
3300 Vista Way
Oceanside, CA 92056
(760) 967-9900
Provider ID: 68200
License: A97469
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Burmese,
Chinese, Mandarin, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Matayoshi, Amy MD
3300 Vista Way Ste B
Oceanside, CA 92056
(760) 967-9900
Provider ID: 54126
License: A60790
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 428
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92102
Quevedo, Juan MD
995 Gateway Center Way Ste
207
San Diego, CA 92102
(619) 263-9729
Provider ID: 252941
License: A144881
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92103
Baranski, Joel MD
4060 4th Ave Ste 220
San Diego, CA 92103
(619) 299-2350
Provider ID: 211830
License: G67559
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Davis, Jason MD
4060 Fourth Ave Ste 220
San Diego, CA 92103
(619) 299-2350
Provider ID: 214288
License: A100799
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hammes, John MD
4060 Fourth Ave Ste 220
San Diego, CA 92103
(619) 299-2350
Provider ID: 214243
License: G84351
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Thomas, Theodore MD
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 429
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Contract terminated as of
8/31/2021
4060 4th Ave Ste 220
San Diego, CA 92103
(619) 299-2350
Provider ID: 241948
License: G61681
Credentials and/or board
certification: Yes
Accepting New Members: No
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92115
Behrend, Terry MD
6402 El Cajon Blvd Ste 100
San Diego, CA 92115
(619) 582-4490
Provider ID: 257272
License: A75812
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No Namazy, David MD
Cultural Competency: NR 6402 El Cajon Blvd Ste 102
Accessibility: B; Members San Diego, CA 92115
should call the provider’s (858) 810-8092
office to discuss their Provider ID: 214330
accessibility needs when there License: A74630
is limited access or when Credentials and/or board
accessibility indicators are not certification: No
present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Le, Charles MD Other Language: Spanish
4440 Euclid Ave Cultural Competency: NR
San Diego, CA 92115 Accessibility: B; Members
(619) 521-6812 should call the provider’s
Provider ID: 238373 office to discuss their
License: A124891 accessibility needs when there
Credentials and/or board is limited access or when
certification: No accessibility indicators are not
Accepting New Members: Yes present.
Hours: M-SA 9AM-5PM
PTA: Yes 92123 Other Language: Spanish,
Vietnamese Behrend, Terry MD
Cultural Competency: NR 8010 Frost St Ste 510
Accessibility: B; Members San Diego, CA 92123
should call the provider’s (619) 582-4490
office to discuss their Provider ID: 214025
accessibility needs when there License: A75812
is limited access or when Credentials and/or board
accessibility indicators are not certification: No
present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 430
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Cultural Competency: NR 8010 Frost St Ste 510 Cultural Competency: NR
Accessibility: B; Members San Diego, CA 92123 Accessibility: B; Members
should call the provider’s (858) 637-4800 should call the provider’s
office to discuss their Provider ID: 214289 office to discuss their
accessibility needs when there License: A100799 accessibility needs when there
is limited access or when Credentials and/or board is limited access or when
accessibility indicators are not certification: No accessibility indicators are not
present. Accepting New Members: Yes present.
Hours: M-SA 9AM-5PM
PTA: No
Chongkrairatanakul, Tepsiri Other Language: Spanish Lund, Guy MD
MD Cultural Competency: NR 8010 Frost St Ste 510
8010 Frost St Ste 510 Accessibility: B; Members San Diego, CA 92123
San Diego, CA 92123 should call the provider’s (858) 637-4700
(858) 637-4700 office to discuss their Provider ID: 214199
Provider ID: 213779 accessibility needs when there License: A68839
License: C157995 is limited access or when Credentials and/or board
Credentials and/or board accessibility indicators are not certification: No
certification: No present. Accepting New Members: Yes
Accepting New Members: Yes Hours: M-SA 9AM-5PM
Hours: M-SA 9AM-5PM PTA: No
PTA: No Faravardeh, Arman MD Other Language: Slovak,
Other Language: Thai 8010 Frost St Ste 510 Spanish
Cultural Competency: NR San Diego, CA 92123 Cultural Competency: NR
Accessibility: B; Members (858) 637-4800 Accessibility: B; Members
should call the provider’s Provider ID: 82852 should call the provider’s
office to discuss their License: A94375 office to discuss their
accessibility needs when there Credentials and/or board accessibility needs when there
is limited access or when certification: No is limited access or when
accessibility indicators are not Accepting New Members: Yes accessibility indicators are not
present. Hours: M-SA 9AM-5PM present.
PTA: No
Other Language: Farsi,
Davis, Jason MD Swedish Patel, Bijal MD
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 431
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
8010 Frost St Ste 510
San Diego, CA 92123
(858) 637-4800
Provider ID: 214154
License: A74638
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92131
Karippot, Anoop MD
10672 Wexford St Ste 280
San Diego, CA 92131
(858) 412-7362
Provider ID: 127806
License: C54071
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Hindi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN YSIDRO
92173
Soltero, Ricardo MD
4004 Beyer Blvd
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 265281
License: A68995
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Neurology
CARLSBAD
92008
Ho, Gilbert MD
5814 Van Allen Way Ste 209
Carlsbad, CA 92008
(760) 814-8050
Provider ID: 212732
License: A55117
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Taiwanese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mehta, Ritvik MD
2390 Faraday Ave
Carlsbad, CA 92008
(858) 909-0770
Provider ID: 240603
License: A93336
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 432
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Gujarati,
Hindi
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92011
Blumenfeld, Andrew MD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 252872
License: A47863
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Choudry, Bilal MD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 252908
License: A114607
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Urdu
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Delaney, Michael MD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-6000
Provider ID: 252864
License: C146015
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Desadier, Laura DO
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 252879
License: 20A14045
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 433
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
accessibility indicators are not
present.
Frishberg, Benjamin MD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 252878
License: G43493
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Gokaldas, Reshma MD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 252862
License: A138459
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Gualberto, Gary MD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 252880
License: C138319
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hall, Jacob MD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 269788
License: A132420
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Lobatz, Michael MD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 252974
License: G38353
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 434
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
PTA: No Lawler, Abigail MD Cultural Competency: NR
Other Language: Hebrew, 6010 Hidden Valley Rd Ste 200 Accessibility: B; Members
Spanish Carlsbad, CA 92011 should call the provider’s
Cultural Competency: NR (760) 631-3000 office to discuss their
Accessibility: B; Members Provider ID: 252955 accessibility needs when there
should call the provider’s License: A152080 is limited access or when
office to discuss their Credentials and/or board accessibility indicators are not
accessibility needs when there certification: No present.
is limited access or when Accepting New Members: Yes
accessibility indicators are not Hours: M-SA 9AM-5PM
present. PTA: No Oh, Irene MD
Other Language: Spanish 6010 Hidden Valley Rd Ste 200
Cultural Competency: NR Carlsbad, CA 92011
Lane, Richard MD Accessibility: B; Members (760) 631-3000
6010 Hidden Valley Rd Ste 200 should call the provider’s Provider ID: 253017
Carlsbad, CA 92011 office to discuss their License: A106450
(760) 631-3000 accessibility needs when there Credentials and/or board
Provider ID: 270431 is limited access or when certification: No
License: A160001 accessibility indicators are not Accepting New Members: Yes
Credentials and/or board present. Hours: M-SA 9AM-5PM
certification: No PTA: No
Accepting New Members: Yes Other Language: Spanish
Hours: M-SA 9AM-5PM Nielsen, Amy DO Cultural Competency: NR
PTA: No 6010 Hidden Valley Rd Ste 200 Accessibility: B; Members
Cultural Competency: NR Carlsbad, CA 92011 should call the provider’s
Accessibility: B; Members (760) 631-3000 office to discuss their
should call the provider’s Provider ID: 277704 accessibility needs when there
office to discuss their License: 20A11494 is limited access or when
accessibility needs when there Credentials and/or board accessibility indicators are not
is limited access or when certification: No present.
accessibility indicators are not Accepting New Members: Yes
present. Hours: M-SA 9AM-5PM
PTA: No Omuro, Arthur DO
Other Language: Spanish 6010 Hidden Valley Rd Ste 200
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 435
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Carlsbad, CA 92011 should call the provider’s Provider ID: 253742
(760) 631-3000 office to discuss their License: A62263
Provider ID: 270477 accessibility needs when there Credentials and/or board
License: 20A15164 is limited access or when certification: No
Credentials and/or board accessibility indicators are not Accepting New Members: Yes
certification: No present. Hours: M-SA 9AM-5PM
Accepting New Members: Yes PTA: No
Hours: M-SA 9AM-5PM Other Language: Spanish
PTA: No Sadoff, Mark MD Cultural Competency: NR
Cultural Competency: NR 6010 Hidden Valley Rd Ste 200 Accessibility: B; Members
Accessibility: B; Members Carlsbad, CA 92011 should call the provider’s
should call the provider’s (760) 631-3000 office to discuss their
office to discuss their Provider ID: 253701 accessibility needs when there
accessibility needs when there License: G42818 is limited access or when
is limited access or when Credentials and/or board accessibility indicators are not
accessibility indicators are not certification: Yes present.
present. Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No Schim, Jack MD
Paduga, Remia MD Other Language: Spanish 6010 Hidden Valley Rd Ste 200
6010 Hidden Valley Rd Ste 200 Cultural Competency: NR Carlsbad, CA 92011
Carlsbad, CA 92011 Accessibility: B; Members (760) 631-3000
(760) 631-3000 should call the provider’s Provider ID: 252939
Provider ID: 252983 office to discuss their License: G48807
License: A113451 accessibility needs when there Credentials and/or board
Credentials and/or board is limited access or when certification: Yes
certification: No accessibility indicators are not Accepting New Members: Yes
Accepting New Members: Yes present. Hours: M-SA 9AM-5PM
Hours: M-SA 9AM-5PM PTA: No
PTA: No Other Language: Spanish
Other Language: Spanish, Sahagian, Gregory MD Cultural Competency: NR
Tagalog 6010 Hidden Valley Rd Ste 200 Accessibility: B; Members
Cultural Competency: NR Carlsbad, CA 92011 should call the provider’s
Accessibility: B; Members (760) 631-3000 office to discuss their
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 436
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Wang, Anchi MD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 52465
License: A79381
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Mandarin,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Wang, Chunyang MD
6010 Hidden Valley Rd Ste 200
Carlsbad, CA 92011
(760) 631-3000
Provider ID: 253007
License: A105660
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Mandarin,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92029
Delaney, Michael MD
1955 Citracado Pkwy Ste 102
Escondido, CA 92029
(760) 631-3000
Provider ID: 252865
License: C146015
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Frishberg, Benjamin MD
1955 Citracado Pkwy Ste 102
Escondido, CA 92029
(760) 631-3000
Provider ID: 252877
License: G43493
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Gokaldas, Reshma MD
1955 Citracado Pkwy Ste 102
Escondido, CA 92029
(760) 631-3000
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 437
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Provider ID: 252863 accessibility needs when there Credentials and/or board
License: A138459 is limited access or when certification: No
Credentials and/or board accessibility indicators are not Accepting New Members: Yes
certification: No present. Hours: M-SA 9AM-5PM
Accepting New Members: Yes PTA: No
Hours: M-SA 9AM-5PM Other Language: Mandarin,
PTA: No Oh, Irene MD Spanish
Other Language: Spanish 1955 Citracado Pkwy Ste 102 Cultural Competency: NR
Cultural Competency: NR Escondido, CA 92029 Accessibility: B; Members
Accessibility: B; Members (760) 631-3000 should call the provider’s
should call the provider’s Provider ID: 253018 office to discuss their
office to discuss their License: A106450 accessibility needs when there
accessibility needs when there Credentials and/or board is limited access or when
is limited access or when certification: No accessibility indicators are not
accessibility indicators are not Accepting New Members: Yes present.
present. Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish Wang, Chunyang MD
Lawler, Abigail MD Cultural Competency: NR 1955 Citracado Pkwy Ste 102
1955 Citracado Pkwy Ste 102 Accessibility: B; Members Escondido, CA 92029
Escondido, CA 92029 should call the provider’s (760) 631-3000
(760) 631-3000 office to discuss their Provider ID: 277705
Provider ID: 252956 accessibility needs when there License: A105660
License: A152080 is limited access or when Credentials and/or board
Credentials and/or board accessibility indicators are not certification: No
certification: No present. Accepting New Members: Yes
Accepting New Members: Yes Hours: M-SA 9AM-5PM
Hours: M-SA 9AM-5PM PTA: No
PTA: No Wang, Anchi MD Other Language: Mandarin,
Other Language: Spanish 1955 Citracado Pkwy Ste 102 Spanish
Cultural Competency: NR Escondido, CA 92029 Cultural Competency: NR
Accessibility: B; Members (760) 631-3000 Accessibility: B; Members
should call the provider’s Provider ID: 252992 should call the provider’s
office to discuss their License: A79381 office to discuss their
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 438
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Blumenfeld, Andrew MD
9850 Genesee Ave Ste 470
La Jolla, CA 92037
(760) 631-3000
Provider ID: 252871
License: A47863
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Blumenfeld, Andrew MD
9850 Genesee Ave Ste 530
La Jolla, CA 92037
(760) 631-3000
Provider ID: 277679
License: A47863
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Gualberto, Gary MD
9850 Genesee Ave Ste 530
La Jolla, CA 92037
(760) 631-3000
Provider ID: 277092
License: C138319
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Kocharian, Naira MD
9850 Genesee Ave Ste 340
La Jolla, CA 92037
(858) 750-2166
Provider ID: 271037
License: A93881
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Armenian,
Russian
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Nielsen, Amy DO
9850 Genesee Ave Ste 530
La Jolla, CA 92037
(760) 631-3000
Provider ID: 277012
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 439
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
License: 20A11494
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sadoff, Mark MD
9850 Genesee Ave Ste 530
La Jolla, CA 92037
(760) 631-3000
Provider ID: 277102
License: G42818
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Sahagian, Gregory MD
9850 Genesee Ave Ste 530
La Jolla, CA 92037
(760) 631-3000
Provider ID: 276977
License: A62263
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
91942
Mohammad, Ahmad Shah MD
8851 Center Dr Ste 307
La Mesa, CA 91942
(619) 337-7900
Provider ID: 212771
License: A98831
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic,
Farsi, French, German,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Kugel, Samuel MD
502 Euclid Ave Ste 305
National City, CA 91950
(619) 472-2600
Provider ID: 244863
License: A54412
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Portuguese,
Spanish
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 440
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
POWAY
92064
Blumenfeld, Andrew MD
15611 Pomerado Rd Ste 505
Poway, CA 92064
(760) 631-3000
Provider ID: 277678
License: A47863
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Delaney, Michael MD
15611 Pomerado Rd Ste 505
Poway, CA 92064
(760) 631-3000
Provider ID: 252866
License: C146015
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Ho, Gilbert MD
15644 Pomerado Rd Ste 401
Poway, CA 92064
(760) 814-8050
Provider ID: 212731
License: A55117
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish,
Taiwanese
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Wang, Anchi MD
15611 Pomerado Rd Ste 505
Poway, CA 92064
(760) 630-3000
Provider ID: 257234
License: A79381
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Mandarin,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 441
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Wang, Chunyang MD
15611 Pomerado Rd Ste 505
Poway, CA 92064
(760) 631-3000
Provider ID: 253008
License: A105660
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Mandarin,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92111
Rim, Choon MD
7825 Engineer Rd Ste 101
San Diego, CA 92111
(858) 277-7111
Provider ID: 126693
License: C50815
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Korean,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92121
Calzada, Audrey MD
5405 Oberlin Dr
San Diego, CA 92121
(858) 909-0770
Provider ID: 275301
License: A107965
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mehta, Ritvik MD
5405 Oberlin Dr Fl 2
San Diego, CA 92121
(858) 909-0770
Provider ID: 257240
License: A93336
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Gujarati,
Hindi
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Obstetrics / Gynecology
CHULA VISTA
91911
Anguiano, Francisco MD
765 Medical Center Ct Ste 209
Chula Vista, CA 91911
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 442
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
(619) 427-8892
Provider ID: 241992
License: G61584
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CORONADO
92118
Sefa-boakye, Kofi MD
230 Prospect Pl Ste 210
Coronado, CA 92118
(619) 435-0041
Provider ID: 209740
License: G59670
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
EL CAJON
92020
Tajran, Deena MD
291 E Lexington Ave # Ac
El Cajon, CA 92020
(858) 578-9600
Provider ID: 204960
License: A55154
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ENCINITAS
92024
Juma, Saad MD
320 Santa Fe Dr Ste 108
Encinitas, CA 92024
(760) 753-8373
Provider ID: 127805
License: A42398
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Kurtulus, Mel MD
9850 Genesee Ave Ste 770
La Jolla, CA 92037
(858) 677-0777
Provider ID: 240578
License: A72728
Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 443
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Turkish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Spring Robinson, Chandra DO
9850 Genesee Ave Ste 770
La Jolla, CA 92037
(858) 677-0777
Provider ID: 245612
License: 20A17561
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
NATIONAL CITY
91950
Aslian, Azita MD
2400 E 8th St
National City, CA 91950
(619) 662-4100
Provider ID: 253065
License: A118227
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Fataleka
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Del Rosario, Gelen MD
502 Euclid Ave Ste 300
National City, CA 91950
(619) 475-1261
Provider ID: 218345
License: A113471
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
OCEANSIDE
92056
Ebrahimi Adib, Tannaz MD
3927 Waring Rd Ste D
Oceanside, CA 92056
(760) 990-7585
Provider ID: 268667
License: A121761
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Persian
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 444
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
is limited access or when
accessibility indicators are not
present.
Mazarei, Rahele MD
3998 Vista Way Ste C
Oceanside, CA 92056
(760) 941-1440
Provider ID: 279184
License: 20A7358
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Farsi,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Suntay, Berk MD
3998 Vista Way Ste C
Oceanside, CA 92056
(760) 941-1440
Provider ID: 279098
License: A124008
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92114
Sefa-boakye, Kofi MD
286 Euclid Ave Ste 205
San Diego, CA 92114
(619) 263-6141
Provider ID: 209741
License: G59670
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish
Cultural Competency: NR
Accessibility: B, W; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92123
Mansour, Anmar MD
7695 Cardinal Ct Ste 370
San Diego, CA 92123
(858) 277-1599
Provider ID: 215785
License: A92470
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92126
Tajran, Deena MD
10737 Camino Ruiz Ste 114
San Diego, CA 92126
(858) 578-9600
Provider ID: 204961
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 445
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
License: A55154
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
92173
Jenkins, Enchanta MD
4050 Beyer Blvd
San Diego, CA 92173
(619) 662-4100
Provider ID: 269687
License: C143625
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN YSIDRO
92173
Carr, Mianda MD
4004 Beyer Blvd
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 269478
License: A104660
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Goldstein, Edward MD
4050 Beyer Blvd
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 244759
License: G20087
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mccullough, Deirdre MD
4050 Beyer Blvd
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 269677
License: C159758
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 446
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
present.
Sefa-boakye, Kofi MD
4004 Beyer Blvd
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 265323
License: G59670
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Westermann, Melissa MD
4050 Beyer Blvd
San Ysidro, CA 92173
(619) 662-4100
Provider ID: 245878
License: A130149
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Oncology Medical
ENCINITAS
92024
Bessudo, Alberto MD
326 Santa Fe Dr Ste 105
Encinitas, CA 92024
(760) 452-3340
Provider ID: 273486
License: A50309
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Hebrew,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Frakes, Laurie MD
326 Santa Fe Dr Ste 105
Encinitas, CA 92024
(760) 452-3340
Provider ID: 273454
License: A52663
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Flores, Edna MD
326 Santa Fe Dr Ste 105
Encinitas, CA 92024
(760) 452-3340
Provider ID: 273539
License: A114373
Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 447
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mcclay, Edward MD
326 Santa Fe Dr Ste 105
Encinitas, CA 92024
(760) 452-3340
Provider ID: 276710
License: G64594
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mcclay, Edward MD
477 N El Camino Real Ste D200
Encinitas, CA 92024
(760) 452-3340
Provider ID: 54083
License: G64594
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Flores, Edna MD
9850 Genesee Ave Ste 560
La Jolla, CA 92037
(858) 552-1410
Provider ID: 273538
License: A114373
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN DIEGO
92127
Eisenberg, Steven DO
16918 Dove Canyon Rd Ste
103
San Diego, CA 92127
(858) 649-5100
Provider ID: 257270
License: 20A8293
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 448
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
is limited access or when
accessibility indicators are not
present.
Flores, Edna MD
16918 Dove Canyon Rd Ste
103
San Diego, CA 92127
(858) 649-5100
Provider ID: 115370
License: A114373
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Lamon, Joel MD
16918 Dove Canyon Rd Ste
103
San Diego, CA 92127
(858) 649-5100
Provider ID: 68222
License: G28164
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: French,
German, Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
SAN MARCOS
92069
Eisenberg, Steven DO
838 Nordahl Rd Ste 300
San Marcos, CA 92069
(760) 747-8935
Provider ID: 257271
License: 20A8293
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Frakes, Laurie MD
838 Nordahl Rd Ste 300
San Marcos, CA 92069
(760) 747-8935
Provider ID: 273453
License: A52663
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Mcclay, Edward MD
838 Nordahl Rd Ste 300
San Marcos, CA 92069
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 449
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
(760) 747-8935
Provider ID: 276709
License: G64594
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Ophthalmology
ALPINE
91901
Binder, Nicholas MD
1620 Alpine Blvd Ste 117
Alpine, CA 91901
(619) 445-2687
Provider ID: 214259
License: A124698
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Patel, Gitane MD
1620 Alpine Blvd Ste 117
Alpine, CA 91901
(800) 898-2020
Provider ID: 244861
License: A108603
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic,
Gujarati, Spanish, Tagalog,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
CHULA VISTA
91910
Bryant, Duane MD
342 F St
Chula Vista, CA 91910
(619) 422-1471
Provider ID: 212675
License: C155562
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Castillejos-rios, David MD
342 F St
Chula Vista, CA 91910
(619) 422-1471
Provider ID: 202144
License: A44482
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 450
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
PTA: No 342 F St Other Language: Arabic,
Cultural Competency: NR Chula Vista, CA 91910 Korean, Mandarin, Spanish
Accessibility: B; Members (619) 422-1471 Cultural Competency: NR
should call the provider’s Provider ID: 265217 Accessibility: B; Members
office to discuss their License: A154697 should call the provider’s
accessibility needs when there Credentials and/or board office to discuss their
is limited access or when certification: No accessibility needs when there
accessibility indicators are not Accepting New Members: Yes is limited access or when
present. Hours: M-SA 9AM-5PM accessibility indicators are not
PTA: No present.
Other Language: Arabic
Castillejos, Maria MD Cultural Competency: NR
342 F St Accessibility: B; Members Carraby, Arnett MD
Chula Vista, CA 91910 should call the provider’s 835 Third Ave Ste A
(619) 422-1471 office to discuss their Chula Vista, CA 91911
Provider ID: 127777 accessibility needs when there (619) 425-7755
License: A37652 is limited access or when Provider ID: 212807
Credentials and/or board accessibility indicators are not License: G47836
certification: Yes present. Credentials and/or board
Accepting New Members: Yes certification: Yes
Hours: M-SA 9AM-5PM 91911 Accepting New Members: Yes
PTA: No Hours: M-SA 9AM-5PM
Other Language: Spanish Abdallah, Walid MD PTA: No
Cultural Competency: NR 835 Third Ave Ste A Other Language: Spanish,
Accessibility: B; Members Chula Vista, CA 91911 Tagalog, Vietnamese
should call the provider’s (619) 425-7755 Cultural Competency: NR
office to discuss their Provider ID: 269257 Accessibility: B; Members
accessibility needs when there License: A146829 should call the provider’s
is limited access or when Credentials and/or board office to discuss their
accessibility indicators are not certification: No accessibility needs when there
present. Accepting New Members: Yes is limited access or when
Hours: M-SA 9AM-5PM accessibility indicators are not
PTA: No present.
Zabaneh, Alexander MD
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 451
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Other Language: Farsi,
Chavez, Cesar MD French, Spanish, Tagalog,
835 Third Ave Ste A Vietnamese Mani, Majid MD
Chula Vista, CA 91911 Cultural Competency: NR 835 3rd Ave Ste A
(619) 425-7755 Accessibility: B; Members Chula Vista, CA 91911
Provider ID: 246267 should call the provider’s (619) 425-7755
License: G51615 office to discuss their Provider ID: 26922
Credentials and/or board accessibility needs when there License: A60640
certification: No is limited access or when Credentials and/or board
Accepting New Members: Yes accessibility indicators are not certification: No
Hours: M-SA 9AM-5PM present. Accepting New Members: Yes
PTA: No Hours: M-SA 9AM-5PM
Other Language: Spanish PTA: No
Cultural Competency: NR Khandan, Sara MD Other Language: Farsi,
Accessibility: B; Members 835 Third Ave Ste A Spanish
should call the provider’s Chula Vista, CA 91911 Cultural Competency: NR
office to discuss their (619) 425-7755 Accessibility: B; Members
accessibility needs when there Provider ID: 269742 should call the provider’s
is limited access or when License: A155828 office to discuss their
accessibility indicators are not Credentials and/or board accessibility needs when there
present. certification: No is limited access or when
Accepting New Members: Yes accessibility indicators are not
Hours: M-SA 9AM-5PM present.
Delengocky, Tayson DO PTA: No
835 3rd Ave Ste A Other Language: Farsi,
Chula Vista, CA 91911 Spanish Mani, Nasrin MD
(619) 425-7755 Cultural Competency: NR 835 3rd Ave Ste A
Provider ID: 78153 Accessibility: B; Members Chula Vista, CA 91911
License: 20A12784 should call the provider’s (619) 425-7755
Credentials and/or board office to discuss their Provider ID: 27356
certification: Yes accessibility needs when there License: A40473
Accepting New Members: Yes is limited access or when Credentials and/or board
Hours: M-SA 9AM-5PM accessibility indicators are not certification: No
PTA: Yes present. Accepting New Members: Yes
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 452
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic,
Faroese, Farsi, Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Montgomery, Gordon MD
835 3rd Ave Ste A
Chula Vista, CA 91911
(619) 425-7755
Provider ID: 272246
License: G31591
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Korean,
Spanish, Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Moss, Jason MD
835 Third Ave Ste A
Chula Vista, CA 91911
(619) 425-7755
Provider ID: 106478
License: A130529
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Papastergiou, Georgios MD
835 3rd Ave Ste A
Chula Vista, CA 91911
(619) 425-7755
Provider ID: 80983
License: A127706
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic,
Farsi, French, Greek, Italian,
Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Pons, Mauricio MD
835 3rd Ave Ste A
Chula Vista, CA 91911
(619) 425-7755
Provider ID: 23410
License: A87650
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 453
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
present. Accepting New Members: Yes accessibility indicators are not
Hours: M-SA 9AM-5PM present.
PTA: No
Peairs, James MD Other Language: Arabic,
835 Third Ave Ste A Russian, Spanish, Tagalog Skaf, Ayham MD
Chula Vista, CA 91911 Cultural Competency: NR 835 3rd Ave Ste A
(619) 425-7755 Accessibility: B; Members Chula Vista, CA 91911
Provider ID: 212798 should call the provider’s (619) 425-7755
License: A155296 office to discuss their Provider ID: 63195
Credentials and/or board accessibility needs when there License: A120584
certification: No is limited access or when Credentials and/or board
Accepting New Members: Yes accessibility indicators are not certification: No
Hours: M-SA 9AM-5PM present. Accepting New Members: Yes
PTA: No Hours: M-SA 9AM-5PM
Other Language: Arabic, PTA: No
Spanish Sassani, Patrick MD Other Language: Arabic,
Cultural Competency: NR 835 Third Ave Ste A Spanish
Accessibility: B; Members Chula Vista, CA 91911 Cultural Competency: NR
should call the provider’s (619) 425-7755 Accessibility: B; Members
office to discuss their Provider ID: 130013 should call the provider’s
accessibility needs when there License: A150205 office to discuss their
is limited access or when Credentials and/or board accessibility needs when there
accessibility indicators are not certification: No is limited access or when
present. Accepting New Members: Yes accessibility indicators are not
Hours: M-SA 9AM-5PM present.
PTA: No
Rajsbaum, Martin MD Other Language: Arabic,
835 Third Ave Ste A Spanish, Tagalog Stainer, Gregory MD
Chula Vista, CA 91911 Cultural Competency: NR 835 Third Ave Ste A
(619) 425-7755 Accessibility: B; Members Chula Vista, CA 91911
Provider ID: 117787 should call the provider’s (619) 425-7755
License: A42670 office to discuss their Provider ID: 269696
Credentials and/or board accessibility needs when there License: G41135
certification: No is limited access or when Credentials and/or board
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 454
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
EL CAJON
92020
Boeckmann, Jessica MD
450 Fletcher Pkwy
El Cajon, CA 92020
(619) 440-5400
Provider ID: 214427
License: A124361
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Arabic,
Armenian, Cantonese,
French, Mandarin, Spanish,
Tagalog, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Special Expertise: HIV/AIDS,
Blindness or Visual Impairment
Hsu, Christopher MD
225 W Madison Ave Ste 1
El Cajon, CA 92020
(800) 898-2020
Provider ID: 279228
License: A65973
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Chinese,
Mandarin, Spanish,
Taiwanese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Learn, Richard MD
225 W Madison Ave Ste 1
El Cajon, CA 92020
(800) 898-2020
Provider ID: 279243
License: A19818
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Miller, Douglas MD
450 Fletcher Pkwy Ste 112
El Cajon, CA 92020
(800) 898-2020
Provider ID: 244937
License: G52627
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog, Vietnamese
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 455
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Patel, Gitane MD
450 Fletcher Pkwy Ste 112
El Cajon, CA 92020
(800) 898-2020
Provider ID: 244862
License: A108603
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Arabic,
Gujarati, Spanish, Tagalog,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Patel, Sarjan MD
450 Fletcher Pkwy Ste 112
El Cajon, CA 92020
(800) 898-2020
Provider ID: 244916
License: A114976
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Gujarati,
Hindi, Spanish, Tagalog,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Prabhu, Sujata MD
450 Fletcher Pkwy Ste 112
El Cajon, CA 92020
(800) 898-2020
Provider ID: 244911
License: A115965
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish,
Tagalog, Telugu, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ENCINITAS
92024
Crosby, Michelle MD
477 N El Camino Real Ste C202
Encinitas, CA 92024
(760) 257-5550
Provider ID: 85965
License: A108687
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 456
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
Culotta, Anthony MD
320 Santa Fe Dr Ste 104
Encinitas, CA 92024
(800) 898-2020
Provider ID: 268887
License: A97142
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Special Expertise: Deafness or
Hard-of-Hearing, Co-occuring
Disorders
Scotti, Frank MD
320 Santa Fe Dr Ste 104
Encinitas, CA 92024
(760) 943-7141
Provider ID: 244904
License: G40698
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
ESCONDIDO
92025
Hudson, Henry MD
830 W Valley Pkwy Ste 300
Escondido, CA 92025
(800) 898-2020
Provider ID: 279226
License: G76091
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Morrison-reyes, Joshua MD
830 W Valley Pkwy Ste 300
Escondido, CA 92025
(760) 743-5872
Provider ID: 275515
License: A125435
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Armenian,
Cantonese, Indonesian,
Mandarin, Spanish, Tagalog,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA JOLLA
92037
Alborzian, Shervin MD
9834 Genesee Ave Ste 209
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 457
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
La Jolla, CA 92037 should call the provider’s License: A97142
(858) 457-2220 office to discuss their Credentials and/or board
Provider ID: 77720 accessibility needs when there certification: No
License: A107093 is limited access or when Accepting New Members: Yes
Credentials and/or board accessibility indicators are not Hours: M-SA 9AM-5PM
certification: No present. PTA: No
Accepting New Members: Yes Cultural Competency: NR
Hours: M-SA 9AM-5PM Accessibility: B; Members
PTA: No Coden, Daniel MD should call the provider’s
Other Language: Farsi, 9850 Genesee Ave Ste 310 office to discuss their
Spanish La Jolla, CA 92037 accessibility needs when there
Cultural Competency: NR (800) 898-2020 is limited access or when
Accessibility: B; Members Provider ID: 204681 accessibility indicators are not
should call the provider’s License: G57587 present.
office to discuss their Credentials and/or board Special Expertise: Deafness or
accessibility needs when there certification: Yes Hard-of-Hearing, Co-occuring
is limited access or when Accepting New Members: Yes Disorders
accessibility indicators are not Hours: M-SA 9AM-5PM
present. PTA: Yes
Cultural Competency: NR Gollogly, Heidrun MD
Accessibility: B; Members 9850 Genesee Ave Ste 310
Avallone, Thomas MD should call the provider’s La Jolla, CA 92037
9850 Genesee Ave Ste 310 office to discuss their (800) 898-2020
La Jolla, CA 92037 accessibility needs when there Provider ID: 275454
(800) 898-2020 is limited access or when License: A134761
Provider ID: 275499 accessibility indicators are not Credentials and/or board
License: A147199 present. certification: No
Credentials and/or board Accepting New Members: Yes
certification: No Hours: M-SA 9AM-5PM
Accepting New Members: Yes Culotta, Anthony MD PTA: No
Hours: M-SA 9AM-5PM 9834 Genesee Ave Other Language: French,
PTA: No La Jolla, CA 92037 German, Spanish
Cultural Competency: NR (800) 898-2020 Cultural Competency: NR
Accessibility: B; Members Provider ID: 268888 Accessibility: B; Members
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 458
SAN DIEGO COUNTY MEDICAL GROUPS HEALTH EXCEL IPA INC
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Hudson, Henry MD
9850 Genesee Ave Ste 310
La Jolla, CA 92037
(800) 898-2020
Provider ID: 279227
License: G76091
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Spanish
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Morrison-reyes, Joshua MD
9850 Genesee Ave Ste 310
La Jolla, CA 92037
(858) 457-3010
Provider ID: 275517
License: A125435
Credentials and/or board
certification: No
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: No
Other Language: Armenian,
Cantonese, Indonesian,
Mandarin, Spanish, Tagalog,
Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Perry, Arthur MD
9850 Genesee Ave Ste 310
La Jolla, CA 92037
(858) 457-3010
Provider ID: 66369
License: C37934
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish,
Tagalog
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
Pratt, Steven MD
9850 Genesee Ave Ste 310
La Jolla, CA 92037
(800) 898-2020
Provider ID: 54350
License: G32379
Credentials and/or board
certification: Yes
Accepting New Members: Yes
Hours: M-SA 9AM-5PM
PTA: Yes
Other Language: Spanish,
Tagalog, Vietnamese
Cultural Competency: NR
Accessibility: B; Members
should call the provider’s
office to discuss their
accessibility needs when there
is limited access or when
accessibility indicators are not
present.
LA MESA
(*) CNP: Certified Nurse Practitioners NP: Nurse Practitioners PA: Physician Assistant CNM: Certified nurse
midwives CNS: Certified Nurse Specialists
Accessibility code explanations: P: Parking EB: Exterior Building IB: Interior Building R: Restroom E:Exam
Room T: Exam Table/Scale W: Wheelchair ME: Medical Equipment SR: Self reported: This information is
self-reported by the provider. Blue Shield Promise Cal Mediconnect Plan has not verified this information
PTA: Public Transportation Accessible within half a mile of provider site. Cultural Competency: CC : Cultural
Competency reported NR: Cultural Competency not reported. Interpreting services are available for all
providers through Blue Shield Promise Cal Mediconnect Plan at no cost. An advance notice is needed for
face-to- face and ASL interpreting services. To request services, contact Blue Shield Promise Cal
Mediconnect Plan Member Services. If you have questions, please call Blue Shield Promise Cal
Mediconnect at 1-855-905-3825 (TTY: 711), 8:00 a.m.– 8:00 p.m., seven days a week. The call is free. For
more information, visit www.blueshieldca.com/promise/calmediconnect. (**)Provides TeleServices Only
Call Member Services if you need information about a provider’s other credentials and/or certifications,
completion of cultural competence training, and/or areas of training and experience. This list is subject to
change 459